Acupuncture for Migraines: What the Research Shows
Updated: 3 minutes ago
If you've lived with migraines for a while, you've probably heard "have you tried acupuncture?" a few times. You may also be wondering whether there's anything real behind it, or whether it's one more thing for the list of things that didn't work.
The research on acupuncture for migraines is encouraging. A 2016 Cochrane review of 22 trials and 4,985 adults found that 41% of people who added acupuncture to usual care had their migraine frequency at least halved, compared with 17% who had usual care alone.
Below I'll go through what that review and a large 2017 trial found, where the evidence is stronger and where it's thinner, and how I use it in clinic.
What does the research say about acupuncture for migraines?
The best evidence is a Cochrane review that pooled 22 randomised trials and found acupuncture reduced migraine frequency in adults with episodic migraine. Cochrane is an international organisation that systematically reviews health research. This Cochrane review of acupuncture for the prevention of episodic migraine, led by Klaus Linde and published in 2016, covered 4,985 people. Episodic migraine means fewer than 15 headache days a month.
The authors concluded that a course of at least six acupuncture sessions can be a valuable option for people with migraine. Their own example: someone averaging six migraine days a month would expect about five with usual care, four with sham acupuncture or a preventive drug, and three and a half with true acupuncture.
That's a realistic, gradual change. It lines up with what I see in clinic, where change usually builds across a series of treatments.
How does acupuncture compare with usual care, sham acupuncture and medication?
Acupuncture beat usual care clearly, beat sham acupuncture by a small margin, and performed about as well as preventive medication, with fewer side effects. Sham acupuncture means needles placed at non-acupuncture points, or needles that don't penetrate the skin. It's used in trials as the "placebo" comparison. The table shows the percentage of people whose migraine frequency at least halved.
Compared with | Acupuncture | Comparison group | What it suggests |
Usual care alone (4 trials) | 41% | 17% | A clear benefit when added to usual care |
Sham acupuncture (14 trials) | 50% | 41% | A small but statistically significant edge |
Preventive drugs at 3 months (3 trials) | 57% | 46% | Acupuncture came out ahead |
Preventive drugs at 6 months (3 trials) | 59% | 54% | No statistically significant difference |
Acupuncture also caused fewer side effects and fewer dropouts than preventive drugs. Side effects and dropouts were similar to sham acupuncture.
What did a large 2017 trial find about long-term results?
A 2017 trial in JAMA Internal Medicine found people who had true acupuncture still had fewer migraine days five months after treatment ended. Ling Zhao and colleagues randomly assigned 249 adults with migraine without aura (2 to 8 attacks a month) to true acupuncture, sham acupuncture or a waiting list. Both acupuncture groups had 20 electroacupuncture sessions over four weeks.
Migraine days per four weeks started at about six in each group. At weeks 13 to 16, they were about 2 in the true acupuncture group, 3 in the sham group and 4 on the waiting list. The gap held through week 24.
Treatment that frequent is more than most people would book in clinic, so treat these numbers as proof of effect, not a template for a treatment plan.
How strong is the evidence for acupuncture and migraines?
Cochrane rated the overall quality of evidence as moderate, which means the findings are useful but not settled. A few limits are worth knowing.
The edge over sham is small. The review's authors say so, and the effect is smaller than the earlier 2009 version of the review found. In my view, that's partly because a true sham is difficult to create. The fact that people get results with sham acupuncture is promising, because it suggests even inaccurate acupuncture can have beneficial effects.
Blinding is hard. In the usual-care and medication comparisons, people knew what they were getting. Acupuncturists can't be blinded to what they're doing either, which can influence results.
Long-term data is thin. Only one trial followed people to 12 months, and the authors note that studies longer than a year are lacking.
The review covered episodic migraine. It tells us less about people with migraine on most days of the month.
What does this mean if you're thinking about acupuncture for migraines?
It means acupuncture is a reasonable option to try, and a block of sessions gives a fairer picture than one visit. The Cochrane trials used courses of at least six sessions, and treatment tends to be cumulative. That's why I look at your response across a run of sessions, then plan from there.
Research tells us what happens on average. In clinic, I'm looking at you. For most people with migraines I look at stress load, tension and trigger points in the neck and upper back, triggers, hormones and digestion, because several of these tend to overlap.
If you'd like to read more, start with the four contributing factors behind many headaches and headache and migraine trigger points, or see whether you have to avoid migraine food triggers forever. For what to expect from treatment, read about how long acupuncture takes to work and how often to come.
FAQs: Acupuncture for Migraines
Does acupuncture work for migraines?
The research suggests it can reduce migraine frequency. In a 2016 Cochrane review, 41% of people who added acupuncture to usual care halved their migraine frequency, versus 17% with usual care alone. Results vary from person to person.
How many acupuncture sessions are needed for migraines?
The Cochrane review concluded that a course of at least six sessions can be a valuable option. Treatment is cumulative, so I assess your response across a block of sessions and adjust the plan as you improve.
Is acupuncture as effective as migraine medication?
In the Cochrane review, 57% of people had their migraine frequency at least halved with acupuncture versus 46% with preventive drugs at three months. At six months the difference wasn't statistically significant (59% versus 54%).
Does acupuncture for migraines have side effects?
In the Cochrane review, side effects and dropouts were similar between acupuncture and sham acupuncture. Acupuncture caused fewer side effects and fewer dropouts than preventive drugs.
Ready to see how your migraines respond?
If you'd like a whole-body approach to your migraines, you're welcome to come and see me. I'll work out what's driving your pattern and put together a plan with you.
If you'd like to try acupuncture for migraines in Sydney's eastern suburbs, come and see me at Acupuncture Grove in Bondi Junction. You can book online here or reach out with a question.
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Gavin Martin-Rentz is an AHPRA-registered acupuncturist and Chinese medicine practitioner at Acupuncture Grove, Bondi Junction, Sydney, with over 10 years in practice.
Acupuncture Grove services Bondi Junction, Bondi Beach, Coogee, Clovelly, Bronte, Waverley, Randwick, Maroubra, Double Bay, Watsons Bay, Vaucluse and surrounding Sydney suburbs.
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