The efficacy of acupuncture for tension-type headache: a systematic review and meta-analysis of randomized controlled trials

Background: Tension-type headache (TTH) is a common primary headache disorder characterized by bilateral, non-pulsating, mild-to-moderate pressing or tightening pain. The objective of this study was to investigate the efficacy of acupuncture for TTH using meta-analysis. Methods: We adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to conduct this research. A systematic search of multiple electronic databases, including PubMed, EMBASE, and the Cochrane Library, was conducted, covering all literature from their inception to August 2024. The articles investigating the efficacy of acupuncture for patients with TTH were included. Meta-analyses were used to pooled the effect size using RevMan 5.4. Results: A total of six randomized controlled trials (including 927 patients) were included. The results revealed the acupuncture group showing significant decrease in headache frequency at 6 weeks post-treatment (standardized mean difference (SMD) = −0.23; 95% confidence interval (CI): −0.43 to −0.03; p = 0.03), while the acupuncture group had higher odds of headache relief when compared with the sham-acupuncture group (odds ratio (OR) = 1.85; 95% CI: 1.34 to 2.57; p < 0.001). In subgroup analysis, acupuncture showed significant decrease in pain level compared to sham-acupuncture when patients received more than one month or 10 treatment sessions (SMD = −0.32; 95% CI: −0.56 to −0.09; p = 0.006). Conclusions: Our results suggest that acupuncture could be effective for TTH when the treatment period extends beyond one month or includes more than 10 sessions. The PROSPERO Registration: Registration number CRD42024602270.

Acupuncture; Tension-type headache; Pain level; Meta-analysis

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