C2 Peripheral Nerve Electroacupuncture Effectively Treats Primary Headache

Peripheral nerve field stimulation with electroacupuncture may represent a less invasive mode of treating primary headache.

Electroacupuncture peripheral nerve field stimulation of the C2 dermatome (EA-C2-PNfS) can reduce severity and disability for patients with primary headache, according to results published in Neuromodulation.

The study included participants with primary headache (n=54) who underwent EA-C2-PNfS for 3 months. The researchers used questionnaires to assess pain intensity (11-point numeric rating scale), quality of daily life (Headache Impact Test-6), and depression (Self-Rating Depression Scale). Participants kept diaries to track monthly headache days and acute headache medication days.

The EA-C2-PNfS reduced participants’ headache intensity significantly, with numeric rating scale pain scores declining from 7.4±1.9 at baseline to 4.9±2.9 at 3 months (P <.001). Headache Impact Test-6 scores also improved significantly from 64.1±6.3 at baseline to 57.8 ±7.9 at 3 months (P <.001).

Monthly headache days decreased significantly from 18.0±9.0 at 1 month to 14.0±10.2 at 3 months (P < .001). Monthly acute headache medication days also decreased significantly from 8.0±6,7 at 1 month to 6.4±6.5 at 3 months (P =.003).

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Before treatment with EA-C2-PNfS, some participants reported moderate depression on the Self-Rating Depression Scale. This was alleviated in participants with tension-type headaches after 3 months of treatment.

“EA-C2-PNfS is a favorable treatment option for medically intractable primary headache as a low-invasive method of neuromodulation,” the authors concluded.


Ishiyama S, Shibata Y, Ayuzawa S, Matsushita A, Matsumara A. Clinical effect of C2 peripheral nerve field stimulation using electroacupuncture for primary headache [published online March 22, 2018]. Neuromodulation. doi:10.1111/ner.12772