Does acupuncture help migraines?
Yes, as prevention. The 2016 Cochrane review of acupuncture for migraine prophylaxis pooled 22 trials with nearly 5,000 patients and found that a course of at least six sessions reduced the frequency of attacks: about 41 percent of patients had their migraine days cut by half or more, compared with 17 percent with usual care alone, and the effect was similar to that of preventive drugs such as beta-blockers and topiramate, with fewer side effects. Acupuncture is less useful during an attack; its role is in reducing how often they come.
What the Cochrane review found, and its caveats
Three comparisons matter. Against no preventive treatment, acupuncture roughly doubled the chance of halving attack frequency. Against sham acupuncture, real acupuncture was slightly better, a small but statistically significant difference, which means part of the effect comes from needling itself and part from the ritual of treatment; the review's authors were candid about that. Against prophylactic drugs, acupuncture was at least as effective at three months and patients dropped out less often because of side effects. The review rated the evidence moderate quality overall.
How acupuncture might prevent attacks
Migraine is a disorder of a sensitized brainstem and trigeminal nerve system, not of blood vessels alone. The proposed mechanisms for acupuncture are the same nervous-system effects seen in other pain conditions: modulation of the trigeminal pain pathway, changes in serotonin and endorphin signaling, and reduced central sensitization over a course of treatment. That fits the pattern in the trials, where benefit builds over six to twelve sessions rather than appearing at once. In Chinese medicine migraines are usually treated as a liver pattern, liver yang rising or liver qi stagnation, in plain words a stress-and-tension pattern that flares upward to the head, with points on the feet, hands, and neck and a herbal formula for the pattern.
A course, and what to track
The trials used 6 to 16 sessions over 8 to 12 weeks, one or two a week. The practice plans a similar course and asks you to keep a headache diary: attack days, intensity, triggers, and medication use. A 50 percent reduction in attack days after the course is the benchmark the research uses, and a diary is the only reliable way to know if you reached it. Medication-overuse headache, from taking painkillers or triptans more than about ten days a month, is common and needs to be addressed alongside, since no preventive works well through it.
Common questions
Can acupuncture stop a migraine once it has started?
Sometimes it eases one, and some patients come in during an attack, but the evidence is for prevention. Acute attacks are the territory of triptans, NSAIDs, and the newer gepants your physician may prescribe.
Should I stop my preventive medication?
No, not without your physician. Acupuncture can be added to a preventive drug, and some patients later reduce the drug with their physician's guidance if attacks fall enough.
Does it help tension-type headaches too?
Yes. A companion Cochrane review found acupuncture reduced the frequency of frequent tension-type headaches, with a similar course of at least six sessions.
General information, not medical advice. Acupuncture and Chinese herbal medicine support, and do not replace, care from your physician. Whether treatment fits your situation is decided at a first visit.