According to a recent study published in the “Journal of Neurology”, the use of acupuncture therapy was found to be safe and effective for the prevention of tension-type headache (TTH). Acupuncture has been reported to minimize TTH frequency in earlier studies. However, frequent significance testing might exaggerate type I error. This systematic review and meta-analysis with trial sequential analysis by Qing-Feng Tao et al. checked the usefulness of acupuncture in reducing TTH episodes.

A database search was performed on Cochrane Library, Ovid Medline and Embase to look for relevant literature (randomized trials evaluating acupuncture with sham acupuncture, no acupuncture, or other active therapies in people with TTH). The frequency of TTH was the key outcome. Responder rate and adverse events were secondary outcomes. Fourteen trials comprising 2795 people with TTH were counted in. In comparison with sham acupuncture, acupuncture had more decrease in TTH frequency, following the use of therapy  (standardized mean difference [SMD] − 0.80) and at the follow-up (SMD − 1.33).

The sample size did not surpass the required information size (RIS) as per the trial sequential analysis. Acupuncture displayed superiority over no acupuncture post-therapy (SMD − 0.52), and the cumulative sample size touched RIS. Acupuncture exhibited a better responder rate than sham acupuncture after the therapy and at follow-up. However, the sample size was insufficient. High-quality studies are required to ascertain the safety and efficacy of acupuncture over sham acupuncture, as concluded by the study investigators.