Does Acupuncture work for Migraine?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Acupuncture is a traditional Chinese medicine technique that has been found to be effective in treating migraines. The exact mechanisms of how acupuncture works for migraines are not fully understood, but several theories have been proposed based on scientific research.

  1. One theory is that acupuncture stimulates the body’s pain-relieving mechanisms. It is believed to stimulate the release of endogenous analgesic substances and promote the body’s healing and blood flow responses.
  2. Neuroimaging studies have suggested that acupuncture can alter the abnormal functional activity and connectivity of the descending pain modulatory system, default mode network, and several related subcortical areas. This alteration in brain activity may help normalize abnormal brain activity and prevent pain signal transmission.
  3. Acupuncture is also thought to have an effect on neuroinflammation, which is associated with migraines. Animal studies have suggested that acupuncture can decrease neuropeptides, immune cells, and proinflammatory and excitatory neurotransmitters, which are associated with the pathogenesis of neuroinflammation.
  4. Furthermore, acupuncture is believed to participate in the development of peripheral and central sensitization through modulation of the release of neuronal-sensitization-related mediators (brain-derived neurotrophic factor, glutamate), endocannabinoid system, and serotonin system activation.

Frequency of treatment for migraines

The recommended frequency of acupuncture sessions for migraine treatment can vary based on the specific protocol used. However, a review of acupuncture protocols in randomized controlled trials suggested that the optimal treatment frequency is twice a week, with one week of rest between the first 10 and the last 10 sessions. The total duration of an acupuncture treatment should be at least 10 weeks.

Another study found that patients with migraines received 12 sessions of acupuncture in addition to prophylaxis treatment.

A different study performed acupuncture once per week for six weeks.

It’s important to note that the frequency and duration of acupuncture sessions can depend on individual factors, including the severity and frequency of migraines, and the patient’s response to treatment.

Does Acupuncture work for migraines?

Several systematic reviews and randomized controlled trials (RCTs) have found that acupuncture can be an effective treatment for migraines.

A systematic review of multiple studies found that acupuncture reduced the frequency and severity of headaches more effectively than Western medicine and sham acupuncture. The review concluded that acupuncture may be an effective and safe therapy for migraines, based on high-quality evidence[1].

Another network meta-analysis compared the effectiveness of botulinum neurotoxin A (BoNT-A), topiramate, and acupuncture in the preventive treatment of chronic migraine. The study found that acupuncture was effective in reducing headache days and migraine days at week 12. Although acupuncture ranked the most effective, no significant difference was found between the three treatments[2].

A randomized controlled trial found that acupuncture combined with tuina (a form of Chinese manipulative therapy) could significantly increase the therapeutic effect of acupuncture in migraine treatment. The study reported a significant reduction in attack frequency, severity of pain, duration of migraine, and associated symptoms at post-treatment and follow-up compared to pre-treatment[3].

A systematic review of experimental studies on rats found that acupuncture significantly reduced behavior scores of rats with migraine and downregulated the expression of certain peptides and proteins associated with pain[4].

A systematic review and Bayesian network meta-analysis of 40 RCTs found that acupuncture outperformed prophylactic drugs in terms of reducing visual analog scale (VAS) score, migraine attack frequency, and headache days during the treatment and at the 12-week follow-up[5].

Is Acupuncture safe for migraines?

Acupuncture is generally considered a safe treatment with few side effects. However, as with any treatment, there can be potential side effects. These can include:

  1. Soreness: After acupuncture, some people might experience temporary soreness or bruising at the needle sites.
  2. Organ injury: If the needles are pushed in too deeply, they could potentially injure an internal organ — particularly in the case of lung puncture (pneumothorax). However, this is an extremely rare occurrence when acupuncture is performed by experienced practitioners.
  3. Infections: Doctors typically use single-use, disposable, sterilized needles. However, if this standard is not met, there is a risk of infection.


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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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