Acupuncture for migraine – treatment and prevention

A recent high-level review investigating acupuncture for migraine treatment suggests that adding acupuncture to symptomatic treatment of attacks reduces the frequency of headaches, and that the effect of acupuncture may be similar to migraine prophylaxis (prevention) drugs, but with fewer adverse effects. (1)

What types of migraines were included in the review?

Migraine is a headache with unilateral (one-sided) pain, pulsating quality, moderate or severe intensity and the symptoms are aggravated by routine physical activity. Migraine may be associated with nausea and/or photophobia (aversion to light) and/or phonophobia (aversion to sounds).

This review focused on episodic migraines (migraine fewer than 15 days per month), which are more common than chronic migraines (migraine more than 15 days per month). The authors required that in each study reviewed, at least 80% of participants had experienced migraine for more than one year.

What was acupuncture treatment compared to in these studies?

Acupuncture was compared to:

• routine treatment (for example, treatment of acute attacks)
• “sham” acupuncture (a procedure that tries to trick participants into believing they are receiving true acupuncture) or
• prophylactic medication.

Acupuncture was not compared to herbal treatments or supplements. Studies comparing two different types of acupuncture were also not included.

How effective is acupuncture treatment for migraine?

The authors of this review looked at what sort of treatment would be needed to reduce migraine frequency by half.

Based on the pooled data of several studies, the review authors estimate that if people have six days with migraine per month on average before starting treatment, this would be reduced to five days in people receiving only usual care, to four days in those receiving fake acupuncture or a prophylactic drug, and to three and a half days in those receiving true acupuncture.

How many sessions of acupuncture are needed for migraine treatment?

In this review, the authors only included studies that gave partipants at least six sessions of acupuncture, and at least at weekly intervals. They deemed that this would be the minimum amount to reasonably expect an effect of treatment. The authors found that likelihood of treatment success increases with the number of sessions. We normally suggest that people have a few sessions of acupuncture before assessing whether they are responding to the treatment.

What long-term benefits can I expect from acupuncture treatment for migraine?

The review authors only included studies that had a follow-up assessment at least eight weeks after the end of acupuncture treatment. The main outcome that the researchers investigated was headache frequency at the end of the treatment course and at follow-up.

They found that acupuncture treatment that is provided in addition to management of acute attacks or to routine care showed postive results for at least three months. Only one study looked at long-term follow-up and it found a small improvement due to acupuncture in addition to routine care after nine months post-treatment (three months of treatment).

The authors suggest that research is now needed to determine whether coming back for another course of treatment would provide further benefits. All studies have only looked at one course of acupuncture treatment (of varying lengths).

Who can benefit from acupuncture treatment for migraine?

The review authors suggest that acupuncture can be considered as a treatment option for people with migraine needing prophylactic treatment because of frequent or inadequately controlled migraine attacks, particularly people refusing prophylactic drug treatment or experiencing adverse effects from such treatment.

What makes Chinese medicine treatment for migraine different from some other approaches?

Because Chinese medicine considers the whole person, at this clinic your treatment plan will often incorporate other signs and symptoms, as these pieces of information are often considered to be interconnected, according to the Chinese medicine view. Chinese medicine strives to view the person in a wholistic way, where all signs and symptoms, strengths and weaknesses are operating in an interconnected web of cause and effect, connecting parts of the body within the person, and connecting the person to their natural and social environment.

How will my acupuncturist assess my migraines?

If you are interested to come to this clinic to receive acupuncture treatment for your migraine, your acupuncturist will review your health history, discuss your whole-person health picture according to Chinese medicine diagnosis and then recommend a treatment plan. Your acupuncturist will discuss a plan that is tailored to you, based on your migraine symptoms and other signs and symptoms, according to how they are assessed with Chinese medicine principles.

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(1) Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6):CD001218. doi:10.1002/14651858.CD001218.pub3