Acupuncture for Headaches & Migraine


In this short article, I shall discuss acupuncture treatment for headaches and migraine. Although I will refer below just to headaches, references should be taken to include migraines. More than ten million people in the UK experience regular headaches, and the condition accounts for 1 in 25 GP consultations.

Acupuncture in Exeter for migraine: model showing the acupuncture meridians of the head, which are important in acupuncture treatment for headaches and migraine.

In 2012, the National Institute for Health and Care Excellence (NICE) issued updated advice to doctors on the treatment of headaches. For tension headaches, acupuncture is recommended as the treatment of choice. For migraine, acupuncture is also suggested where the usual drugs are either ineffective or unsuitable. More recently, the prestigious Cochrane Collaboration has supported the use of acupuncture to treat tension headaches. For migraine, Cochrane says acupuncture compares favourably with drug treatment, citing fewer adverse effects and greater likelihood of responding.

A large review funded by the National Institute for Health & Care Research in 2017, concluded that acupuncture is better than usual care for pain from chronic headaches.

You can also read in the prestigious journal Neurology Today, an account of how two American neurology professors make use of acupuncture to treat headaches. One says, “I can tell you that it’s not controversial within our neurology department. Everybody embraces it and has been able to see the value in it.”

Treating Headaches

Headaches in my experience are generally very responsive to acupuncture, and I always find them interesting complaints to treat. I begin by finding out from you all about the nature of your headaches. Often they will have been going on for a while, and you’ll be readily able to answer questions about their characteristics. You may or may not have a diagnosis from your doctor, but one of my jobs is to formulate a Chinese medical diagnosis. I will ask you about the location of the pain (eg forehead, temples, back), its nature (eg dull, heavy, throbbing), any accompanying symptoms (eg nausea, visual disturbance), any trigger factors (eg stress, weather, tiredness, tight shoulders), and timing (eg time of day, weekdays, weekends, premenstrually, even a seasonal surge).

We will cover any medication you have tried and any other treatment to date. We will examine your health and wellbeing in a wider sense, to see whether there is anything else which I might connect with your headaches.

I will usually offer treatment weekly for a set period, or twice per week initially if your headaches are particularly severe and frequent. I might ask you to keep a simple headache diary so that as the weeks go by, we can measure your progress. There will usually be some lifestyle recommendations to help you as well.

Regarding migraine specifically, the charity Migraine Action has in the past given its “Best Complementary Therapist for Treatment of Migraine” award, to a traditional acupuncturist.

Please do call me to discuss your situation or to arrange an appointment. Below you can read the results of some of the research which has been undertaken into acupuncture for headaches and migraine. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.

Acupuncture can help Prevent Migraines

Acupuncture can help prevent migraines, according to the authors of a systematic review. Their network meta-analysis included 40 randomised controlled trials, covering over 4400 participants, and compared the effectiveness of various acupuncture techniques with three prophylactic drugs and psychotherapy.

Acupuncture was found to be more effective than prophylactic drugs in reducing pain scores, frequency of attacks, and number of headache days during treatment and at 12-week follow-up.

(Effectiveness of Acupuncture for Prophylactic Treatment of Migraine: A Systematic Review and Bayesian Network Meta-Analysis. Advanced Biology, 6 July 2023.)

Acupuncture Reduces Stroke Risk in Migraine Patients

Acupuncture reduces stroke risk in migraine patients. Numerous studies, including five meta-analyses, have linked migraine, particularly migraine with aura, with increased risk of ischaemic stroke. The relative risk of ischaemic stroke is doubled in people with migraine with aura compared with migraine-free individuals. (1)

Now a large retrospective cohort study in Taiwan suggests that acupuncture is effective at reducing the risk of stroke in patients with migraine. The university-based authors collected data from a national insurance database on all newly diagnosed migraine patients over an 18 year period, and assigned them to an acupuncture or non-acupuncture cohort. They then followed them up until the end of 2018. Each cohort consisted of 1354 patients with similar baseline characteristics.

On analysis, the acupuncture cohort showed significantly less risk of stroke across male and female patients, and the authors conclude that these findings support the use of acupuncture in migraine patients to reduce long-term stroke risk.

(Acupuncture Is Effective at Reducing the Risk of Stroke in Patients with Migraines: A Real-World, Large-Scale Cohort Study with 19-Years of Follow-Up. International Journal Environmental Research & Public Health, 17 January 2023.)

(1) Migraine and risk of stroke. Journal of Neurology, Neurosurgery & Psychiatry, Volume 91, Issue 6.

Acupuncture Relieves Tension Headaches

Acupuncture relieves tension headaches. Research lead by Hannover Medical school in Germany has shown that acupuncture, either alone or combined with physiotherapy exercise, is associated with positive effects on symptom intensity, quality of life, anxiety and depression, in patients with tension headaches. They randomised 96 adults, mean age 39, with frequent episodic or chronic tension headaches, to one of four treatment groups: acupuncture, physiotherapy, both of the foregoing, or usual care. Patients were recruited via pain clinics, primary care and regional media. Treatment was given for six weeks. No severe adverse events occurred.

Depression scores for the acupuncture and acupuncture-plus-physiotherapy groups, were significantly lower than in the physiotherapy and usual care groups. Similar results were found for anxiety and physical functioning, and the benefits of acupuncture persisted at six month follow-up.

(Effects of acupuncture and medical training therapy on depression, anxiety, and quality of life in patients with frequent tension-type headache: A randomized controlled study. Cephalalgia, 9 January 2023.)

Acupuncture helps Migraine

Acupuncture helps migraine. Chinese researchers studying whether acupuncture helps migraine, have performed a meta-analysis of trials, to compare acupuncture with both botox and topiramate. They looked at 15 randomised controlled trials covering 2545 patients.

Analysis showed that acupuncture and topiramate were most effective in reduction of monthly headache and migraine days, with botox following closely behind. Acupuncture though, resulted in the fewest treatment-induced adverse events. Topiramate caused the most adverse events and consequently the highest rate of dropouts.

(Topiramate, acupuncture, and BoNT-A for chronic migraine: a network meta-analysis. Acta Neurologica Scandinavica, 3 January 2021.)