Helix Clinic blog

The Cochrane Collaboration regularly publishes respected reviews on the effectiveness of different medical treatments, and recently published a review that confirmed the beneficial effect of acupuncture for headache. They analysed 33 separate studies that involved nearly 7000 patients once they had collated the results.

Researchers reviewed trials of acupuncture for tension headaches (usually affecting both sides of the head) as well as migraines, and in both cases found that many patients experienced fewer headaches or migraines after having acupuncture. After an 8 week course of treatment, patients who had acupuncture with no painkillers tended to suffer with less headaches compared to those who were given only painkillers.

The results also indicated that positive effects were observed even if the needles were placed incorrectly according to traditional texts. This raises the often mentioned possibility of non-specific needle effects and/or placebo effects. We do not see a problem with placebo effects, as our primary concern is for the well-being of the patient. If a patient can get better thanks to a combination of acupuncture and the power of the mind, that has to be better than staying hooked on a long-term course of powerful painkilling drugs and all their associated side effects.

It is extremely likely that placebo effects have a part to play in the overall experience of acupuncture, but it is very unlikely to be the whole story. There have been a number of recent fMRI studies that point to definite physiological effects due to specific needling. In addition, anectodal evidence suggests acupuncture is effective on animals as well as humans, which is much harder to explain by recourse to the placebo effect. The overall findings of this Cochrane study are interesting and as usual, point to a need for further research.

Tags: Cochrane review, headaches, migraines

An interesting paper was published in 2008 in the BMJ, by Bhattacharaya et. al., that raises questions about the effectiveness of two of the most commonly used treatments for couples with unexplained infertility (a quarter of all couples with fertility problems have unexplained infertility).

Clomifene (or Clomid) is a medicine that stimulates a woman’s ovaries to produce more eggs, and IUI (intrauterine insemination) is a procedure that involves injecting sperm directly into the womb. Both of these treatments are currently endorsed in the UK by the NICE fertility guidelines for couples with unexplained infertility.

The research paper is interesting because it suggests that these treatments are no more effective than waiting for 6 months without treatment. The likelihood of falling pregnant during the study’s 6 month period was the same for all couples, whether they had one of the treatments or not.

The research is convincing because it included 580 couples and adhered to the strict standards of a randomised controlled trial, making it one of the largest good quality studies of this type of infertility. So if you have unexplained infertility and have been offered clomifene or IUI, it would be worth mentioning this study to your consultant and asking why they think this treatment would be relevant for you.

Tags: clomid, clomifene, infertility, IUI