What role can acupuncture play in concussion recovery?

Post-concussion syndrome

There is actually a larger body of scientific evidence for acupuncture than most people are aware of. This is why acupuncture is often recommended as a non-pharmacological management of chronic post concussion headaches. 

These treatment programs should be implemented based on patient-specific assessment findings and patient tolerance. I do not treat the concussion directly, instead I treat the impairments that may be related to or irritating one. Tension headaches as a result of whiplash associated disorders (WAD) are often confused for a symptom of a post-concussion syndrome, acupuncture can be used as a therapeutic intervention will reduce the risk of cervicogenic headaches developing into chronic post concussion headaches. 

*I highly recommend that all rehabilitation plans are coordinated with the primary physician who is overseeing the care of the patient.

Acupuncture Evidence of Efficacy for Neck Pain

Cochrane Reviews

The Cochrane Reviews are considered by many to be the gold standard when it comes to research because they tend to be more rigorous, transparent, independent, and up-to-date than other reviews. Using the Cochrane reviews as a benchmark for clinical evidence there seems to be compelling evidence that when acupuncture is used as part of an evidence based treatment it can be a valuable option for : tension type headaches, neck pain and episodic migraine.

Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Vertosick, E. A., . . . White, A. R. (2016). Acupuncture for the prevention of episodic migraine. Cochrane Database of Systematic Reviews.

Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B., . . . White, A. R. (2016). Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews.

Trinh, K., Graham, N., Irnich, D., Cameron, I. D., & Forget, M. (2016). Acupuncture for neck disorders. Cochrane Database of Systematic Reviews.

Other High Impact Journals

Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain. (2015). Annals of Internal Medicine.
* In this study 517 patients were recruited and pain was assessed using the Northwick Park Questionnaire (NPQ). At the 12-month mark, patients who received acupuncture had a to significant reductions in neck pain and associated disability compared with usual care.

Coeytaux, R. R., & Befus, D. (2016). Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders. Headache: The Journal of Head and Face Pain.

Witt, C. M., Jena, S., Brinkhaus, B., Liecker, B., Wegscheider, K., & Willich, S. N. (2006). Acupuncture for patients with chronic neck pain. Pain
* This was a large study of 14,161 patients, that concludes that treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., Macpherson, H., Foster, N. E., . . . Collaboration, F. T. (2012). Acupuncture for Chronic Pain. Archives of Internal Medicine.
* This was a large meta-analysis found pain scores improved through acupuncture by 0.23 standard deviation (SD) for neck pain and back pain. In this paper researchers looked at all accumulated randomized controlled trials in examining how acupuncture fared in treating people with chronic pain. Acupuncture outperformed controls, even after they omitted studies that seemed prone to bias and even after they did some tests to assess the likelihood of publication bias. “Not only did acupuncture work better than no acupuncture control groups, there were significant differences between acupuncture and sham acupuncture.”  (This would suggest that not all benefits are placebo)

Vickers, A. J., & Linde, K. (2014). Acupuncture for Chronic Pain. JAMA.
* For chronic headaches, a large meta-analysis found an improvement of 0.15 SD in pain scores with acupuncture when compared with sham acupuncture and 0.42 SD in patients receiving no acupuncture

Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., . . . Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current Pain and Headache Reports, 20(4).

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