Chronic migraine and chronic tension-type headache
Headaches are among the most common reasons for patient visits in primary care and neurology settings. Migraines are the second most frequently occurring primary headaches. Interventions for treatment of headaches include botulinum toxin injections, trigger point injections, transcranial magnetic stimulations, acupuncture, manipulation, manual therapy, and massage. Acupuncture involves the placement of thin needles (with or without manual or electrical stimulation) along specific pathways, meridians, trigger points, or pain points based on the condition being treated.
Chronic migraine and chronic tension-type headache was first reviewed in 2017.
- In 2018, the clinical committee voted to restate the language of the original coverage decision to clarify eligibility requirements.
- In February 2021, a signal search for chronic migraine and chronic tension-type headache medical literature was conducted to determine if newly available published evidence could change the original coverage decision. The technology was not selected for rereview.
- In July 2021, the HCA director selected this topic for rereview based on published evidence regarding the use of acupuncture for chronic migraine and chronic tension-type headaches that could change the original coverage determination.
Why are chronic migraine and tension-type headache being reviewed?
The topics are proposed to determine the safety, efficacy, and value of interventions for treatment of migraines and other headache types. The topics were selected based on medium/high concerns for safety, efficacy, and cost.
Primary criteria ranking
- Safety = Medium/High
- Efficacy = Medium/High
- Cost = Medium/High
Documentation
| Type | Materials |
|---|---|
| Current final determinations |
|
| Assessment (2022) |
Acupuncture for chronic migraine and chronic tension-type headache. Includes updated decision on acupuncture, which supersedes 2017 acupuncture decision. For information on other modalities reviewed, see Assessment (2017). |
| Update literature (2021) |
Acupuncture for chronic migraine and chronic tension-type headache |
| Assessment (2017) |
Treatment of chronic migraine and chronic tension-type headache |
Assessment timeline
- Draft key questions published: September 3, 2021
- Public comment period: September 3 to September 16, 2021
- Final key questions published: September 30, 2021
- Draft report published: January 18, 2022
- Public comment period: January 18 to February 17, 2022
- Final report published: February 25, 2022
- HTCC public meeting: March 18, 2022