Can Acupuncture Treat Headache and Migraine? – Evidence Review

Can acupuncture help to treat headache and migraine? This is a question that I often get, and as it is one of the most well researched areas for acupuncture treatment, I am writing this to give you a short summary of what the evidence says. This is for information only, and is not intended to replace your doctor’s advice.

A large systematic review published in the Journal of Pain in 2018, found that acupuncture is an effective treatment, that true acupuncture was superior to sham or placebo acupuncture as well as non-acupuncture controls, and that the majority of the effects of acupuncture persist for at least a year after concluding treatment.

A review in the journal, Current Opinion in Anaesthesiology, concluded that there is mounting evidence which supports the effectiveness of acupuncture to treat headaches, as well as other forms of pain. They state that additional data is emerging that supports the use of acupuncture as an adjunct or alternative to opioids, and in perioperative settings.

Two Cochrane reviews – relating to tension-type headache and episodic migraine, both concluded that acupuncture is effective for these conditions. Interestingly here, the effect of sham or placebo acupuncture, while less than the effect of true acupuncture, was still higher than one might expect.

There are many randomised controlled trials published on the effectiveness of acupuncture for migraine and headache. One which was published in the British Medical Journal in 2020, subsequent to the two Cochrane reviews mentioned, specifically addressed two difficulties that have hampered acupuncture research in the past – those being blinding of patients to whether they were in the treatment group or not, and also the use of a truly inert sham or placebo by using specially designed non-penetrative acupuncture needles. This trial showed a significant difference in results between the true acupuncture group and the placebo group, finding true acupuncture to be an effective treatment. They also verified that patients could not tell whether they were in the treatment or placebo group.

The UK’s National Institute for Health and Care Excellence publish clinical healthcare guidelines for the UK, and they recommend acupuncture for treatment of chronic tension-type headaches and migraines.

The German Migraine and Headache Society and the German Society of Neurology issued guidelines on the treatment of migraine attacks and prevention of migraine, in which they state that there is evidence that acupuncture can be effective in treatment of acute migraine attacks. The same guidelines also recommend acupuncture for migraine during pregnancy.

So, can acupuncture help with headache and migraine? There certainly is strong evidence which supports this. Here are some additional things that you should note though.

  1. Firstly, I am an acupuncturist, so you should be aware that my opinion is somewhat biased. You will easily find opinions that are biased against acupuncture too. What I will do is provide all of the research references mentioned here so that you can check them out yourself.
  2. Secondly, high quality acupuncture trials are difficult to design and run, so some systematic reviews have struggled to find enough good studies on which to draw a conclusion. I mentioned patient blinding and placebo control above, which are two examples of where acupuncture research is particularly tricky.
  3. Third, please bear in mind that like any profession, there are good acupuncturists and there are bad ones. If you are going to try acupuncture, check that your acupuncturist is a member of the ACI or the AFPA at a minimum (in Ireland), that they are knowledgeable and experienced, they have continued to upskill after graduating, and that you feel like they are professional and trustworthy.
  4. Lastly, a fundamental concept in Traditional Chinese Medicine is to try and understand and deal with the root cause of the illness. Headache and migraine can be caused by many things, including poor sleep, dietary factors, chronic stress, infections etc.– and it is important that these are accounted for, whether or not acupuncture is being used.

In conclusion, there is high quality evidence that acupuncture can help to treat headache and migraine.

If you are going to try it, be sure to work with the right practitioner, and that the root cause is being addressed.

 

Seamus Fitzgerald, Réiteach Integrative Health.

Acupuncture and Chinese Herbal Medicine. Dungarvan, Co. Waterford.

 

References

  1. Vickers, A.J. et al. (2018) (Acupuncture Trialists’ Collaboration) ‘Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis’. J Pain, 19(5), pp. 455-474.
  2. Yin, C., Buchheit, T.E. and Park, J.J. (2017) ‘Acupuncture for chronic pain: an update and critical overview’. Current Opinion in Anaesthesiology, 30(5), pp. 583-592.
  3. Linde, K. et al. (2016) ‘Acupuncture for the prevention of tension-type headache’. Cochrane Database of Systematic Reviews, (4), Art. No.: CD007587.
  4. Linde, K. et al. (2016) ‘Acupuncture for the prevention of episodic migraine’. Cochrane Database of Systematic Reviews, (6), Art. No.: CD001218.
  5. MacPherson, H. et al. (2014) (Acupuncture Trialists’ Collaboration) ‘Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis’. PLoS One, 9(4):e93739
  6. MacPherson, H. et al. (Acupuncture Trialists’ Collaboration) (2017) ‘The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain’. Pain, 158(5), pp. 784-793.
  7. Xu, S., et al. (2020) ‘Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial’. BMJ, 368:m697.
  8. National Institute for Health and Care Excellence (NICE) (2025) Headaches in over 12s: diagnosis and management. Available at: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations#management-2 (Accessed: 10 June 2025).
  9. Diener, H.C. et al. (2019) ‘Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology’. Clinical and Translational Neuroscience, 3(1).
  10. Johns Hopkins Medicine (2025) Acupuncture. Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture (Accessed: 10 June 2025).
  11. Mayo Clinic (2023) Migraine headache: diagnosis and treatment. Available at: https://www.mayoclinic.org/diseases-conditions/migraine-headache/diagnosis-treatment/drc-20360207 (Accessed: 10 June 2025).