AURICULAR ACUPUNCTURE IN THE MANAGEMENT OF TENSION-TYPE HEADACHE: A PRELIMINARY STUDY

S. Sorrenti¹, M. Ciuffreda¹, E. Pisello¹, L. Brugiaferri², A. Federici², C. Piangatelli³, D. Galante⁴ | ¹U.O.C. Anesthesia Resuscitation Pain Therapy, AST Ancona, Fabriano (AN); ²Residency School. Anesthesia, Resuscitation, Intensive and Pain Therapy, Università Politecnica delle Marche, Ancona; ³U.O.C. Anesthesia, Resuscitation Pain Therapy Director, AST Ancona, Fabriano (AN); ⁴U.O.C. Anesthesia and Resuscitation, Director, Cerignola (FG)

INTRODUCTION
Tension-type headache (TTH) is a common form of primary headache, often managed with symptomatic treatment such as non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. However, pharmacological approaches may lead to medication overuse and fail to address the underlying causes. Auricular acupuncture has shown promise in modulating pain pathways and muscle tension. This study aims to evaluate the efficacy and safety of auricular acupuncture in reducing the impact of TTH in adult women.
METHODS
A prospective observational study was conducted on 20 female patients aged 30 to 50 years with a positive history of TTH and ongoing symptomatic treatment with NSAIDs and muscle relaxants. Each participant underwent auricular acupuncture sessions using sterile, single-use needles (0.2 × 40 mm) applied bilaterally to specific auricular points: master cerebral point, thalamus point, paravertebral cervical musculature, occiput, and a muscle-relaxant point. Needles were retained for 20 minutes, followed by application of auricular plasters with embedded needles (0.15 × 0.6 mm), which were worn for 5 days and self-removed. Treatments were administered weekly during the first month and biweekly during the second month. To assess impact on quality of life and headache-related disability, patients completed the Headache-Attributed Lost Time (HALT) questionnaire: HALT-90 at baseline (T0), HALT-30 after 1 month, and again HALT-30 at 2 months. HALT-90 assesses disability over the prior 3 months, while HALT-30 evaluates the previous 30 days.
RESULTS
At baseline (T0), 15 patients reported moderate impact (Grade 3) and 5 reported mild impact (Grade 2) on the HALT-90 scale. After 1 month of treatment, HALT-30 scores indicated a reduction in disability: 5 patients showed moderate impact (Grade 2), and 15 showed mild impact (Grade 1). By the end of the second month, 15 patients reported mild impact (Grade 2), and 5 reported minimal impact (Grade 1). Additionally, all patients demonstrated a reduced need for symptomatic medication. No adverse effects or contraindications were observed throughout the study period.
CONCLUSIONS
Auricular acupuncture appears to be a safe and effective complementary approach in reducing the frequency and impact of tension-type headaches. This technique also contributes to a decreased reliance on symptomatic drugs. Further randomized controlled trials with larger sample sizes are recommended to validate these preliminary findings.