Acupuncture Continuing Education

Acupuncture Proven Effective For Migraine Relief

acupuncture migraine

Acupuncture is a cost-effective and safe treatment modality for the alleviation or elimination of migraine headaches. Harvard Medical School, Georgetown University, University of Arizona, Creighton University, and Louisiana State University researchers report findings showing that acupuncture reduces the frequency, intensity, and duration of migraine attacks. [1] The investigation team indicates that patients receiving acupuncture are also less prone to secondary anxiety attacks and depression.

Globally, migraines afflict 14.7% of the world’s population. [2] According to Mayo Clinic research, 1.5% of the USA population has received acupuncture treatment; however, migraines afflict 15.3% of the USA population. [3] Females are disproportionately affected, with 9.7% of males and 20.7% of USA females suffering from migraines. [4]

The research team notes that their findings are consistent with multiple studies and prior investigations. A Cochrane Systematic Review concludes that acupuncture reduces that duration and frequency of migraines. [5] The team points out that numerous studies conclude that true acupuncture is superior to sham acupuncture intervention. [6, 7]

The meta-analysis included many sources of research, including a pivotal piece of research completed in 2018. Researchers discovered specific neurochemical responses to acupuncture using magnetic resonance spectroscopy. This type of imaging is similar to conventional MRI; however, magnetic resonance spectroscopy adds the use of ions or protons to measure chemical metabolism changes in the brain. Using this highly advanced technology, the researchers made an important discovery.

Brain metabolites (e.g. N-acetylaspartate, creatine) are involved in the transmission of pain due to migraines. For example, N-acetylaspartate (NAA) levels decrease during migraine attacks. Magnetic resonance spectroscopy confirms that acupuncture causes a significant increases in N-acetylaspartate and creatine levels in the thalamus. The increases provided by acupuncture therapy were correlated with decreases in migraine headache intensity levels. [8] As a result, acupuncture’s effects on normalizing brain metabolic activity demonstrates a role in reducing pain due to migraines.

Another study in the review finds auricular acupuncture (ear acupuncture) effective for reducing the number of migraine days per month for patients suffering from chronic migraines after one month of acupuncture therapy. [9] In 2020, a groundbreaking retrospective study of 21,209 patients with migraines confirms the efficacy of acupuncture. Acupuncture was found cost-effective for the treatment of migraines. Moreover, acupuncture reduced the risk of depression and anxiety. A thirteen-year follow-up reveals that migraine patients receiving acupuncture had significantly less incidences of both depression and anxiety. [10]

The university researchers reviewed many more investigations in their meta-analysis. To ensure conclusions were based on quality data, randomized controlled trials using strict sham controls were evaluated. Consistently, real acupuncture produced superior patient outcomes when compared with sham acupuncture. [11]

A 2018 study took a specific look at how acupuncture produces immediate relief. Acupuncture was found effective for the reduction of migraine intensity directly after acupuncture therapy. [12] This supplements the findings of other investigations finding acupuncture effective in producing long-term results. Another double-blinded, multicenter randomized controlled trial reported in the meta-analysis finds acupuncture effective for preventing migraine attacks. After 20 acupuncture visits, the incidence of migraine attacks dropped significantly when compared with sham controls. [13]

One important study included in the meta-analysis finds acupuncture more effective than pharmacological intervention. After 12 weeks of acupuncture or drug therapy, the acupuncture group had significantly fewer days with migraines. The results were immediate and a 6 month follow-up (post-treatment) confirmed that acupuncture produced fewer days with migraines. [14]

Another investigation compared the efficacy of three treatment modalities for migraine sufferers: botulinum toxin-A, sodium valproate, and acupuncture. Acupuncture produced the greatest reduction of pain intensity levels at the conclusion of the three month investigation. [15] The researchers note that all three methods produced results, but acupuncture produced superior clinical outcomes with fewer adverse events.

Another study in the meta-analysis was originally published in JAMA Internal Medicine (journal of the American Medical Association). The three-arm investigation compared true acupuncture, sham acupuncture, and a control group. True acupuncture produced less migraine attacks, less total days with migraines, and less overall migraine symptoms when compared with the sham and control groups. [16]

The study also looked at other meta-analyses. One meta-analysis of ten randomized controlled trials involving 997 participants found true acupuncture more effective than sham acupuncture. True acupuncture produced a lower recurrence rate of migraines than sham acupuncture. [17] Another meta-analysis of 62 clinical trials involving 4,947 participants found that acupuncture produced superior clinical outcomes one month after treatment when compared to pharmacological medications. The researchers concluded that “acupuncture is more effective than no treatment, sham treatment, or medication in treating and preventing migraines and that it is also associated with a greater enhancement in quality of life compared to medication.” [18]

Another meta-analysis included 13 randomized controlled trials involving 1,559 patients. The investigators determined that acupuncture is effective for the treatment of migraines and shows signs of effective treatment for depression and anxiety as well. [19] Another meta-analysis of 22 trials involving 4,985 patients concludes that true acupuncture is more effective for the treatment of migraines than both sham acupuncture and medications. They formally recommend acupuncture as adjunct care to reduce the frequency of migraine attacks. [20]

One fMRI study reviewed in the meta-analysis finds acupuncture effective in restoring normal brain connectivity for patients with migraines, thereby effectively treating the condition by producing significant therapeutic neural responses. The researchers concluded that decreased right frontoparietal network functional connectivity imbalances can be reversed by acupuncture therapy for patients with migraines. [21]


[1] Urits, Ivan, Megha Patel, Mary Elizabeth Putz, Nikolas R. Monteferrante, Diep Nguyen, Daniel An, Elyse M. Cornett, Jamal Hasoon, Alan D. Kaye, and Omar Viswanath. "Acupuncture and Its Role in the Treatment of Migraine Headaches." Neurology and Therapy (2020): 1-20. Author Affiliations:
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center— Harvard Medical School, Boston, Massachusetts.
Department of Anesthesiology, University of Arizona College of Medicine–Phoenix, Phoenix, Arizona.
Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska.
Georgetown University School of Medicine, Washington, DC.
Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, Louisiana.
Valley Pain Consultants–Envision Physician Services, Phoenix, Arizona.

[2] Natoli J, Manack A, Dean B, et al. Global prevalence of chronic migraine: a systematic review. Cephalalgia. 2010;30(5):599–609.
[3] Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clin Proc. 2016;91(9): 1292–306.
[4] Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States. Mayo Clin Proc. 2016;91(9): 1292–306.
[5] Coeytaux RR, Befus D. Role of acupuncture in the treatment or prevention of migraine, tension-type headache, or chronic headache disorders. Headache. 2016;56(7):1238–40.
[6] Zhang X-T, Li X-Y, Zhao C, et al. An overview of systematic reviews of randomized controlled trials on acupuncture treating migraine. Pain Res Manag. 2019;2019:5930627.
[7] Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain. 2019; 20:57.
[8] Gu T, Lin L, Jiang Y, et al. Acupuncture therapy in treating migraine: results of a magnetic resonance spectroscopy imaging study. J Pain Res. 2018;11: 889–900.
[9] Allais G, Sinigaglia S, Airola G, et al. Ear acupuncture in the prophylactic treatment of chronic migraine. Neurol Sci. 2019;40(1):211–2.
[10] Liao C-C, Liao K-R, Lin C-L, Li J-M. Long-term effect of acupuncture on the medical expenditure and risk of depression and anxiety in migraine patients: a retrospective cohort study. Front Neurol. 2020;11: 321.
[11] Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z, Sherman KJ. Acupuncture for frequent migraine: a randomized, patient/assessor blinded, controlled trial with one-year follow-up. Evid Based Complement Altern Med. 2015;2015:920353.
[12] Farahmand S, Shafazand S, Alinia E, Bagheri-Hariri S, Baratloo A. Pain management using acupuncture method in migraine headache patients; a single blinded randomized clinical trial. Anesthesiol Pain Med. 2018;8(6):e81688.
[13] Xu S, Yu L, Luo X, et al. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ. 2020;368:m697.
[14] Musil F, Pokladnikova J, Pavelek Z, Wang B, Guan X, Valisˇ M. Acupuncture in migraine prophylaxis in Czech patients: an open-label randomized controlled trial. Neuropsychiatr Dis Treat. 2018;14: 1221–8.
[15] Naderinabi B, Saberi A, Hashemi M, et al. Acupuncture and botulinum toxin A injection in the treatment of chronic migraine: a randomized controlled study. Casp J Intern Med. 2017;8(3): 196–204.
[16] Zhao L, Chen J, Li Y, et al. The long-term effect of acupuncture for migraine prophylaxis a randomized clinical trial. JAMA Intern Med. 2017;177(4): 508–15.
[17] Yang Y, Que Q, Ye X, Hua ZG. Verum versus sham manual acupuncture for migraine: a systematic review of randomised controlled trials. Acupunct Med. 2016;34(2):76–83.
[18] Jiang Y, Bai P, Chen H, Zhang XY, Tang XY, Chen HQ, et al. The effect of acupuncture on the quality of life in patients with migraine: a systematic review and meta-analysis. Front Pharmacol. 2018;9: 1190.
[19] Li X, Dai Q, Shi Z, et al. Clinical efficacy and safety of electroacupuncture in migraine treatment: a systematic review and network meta-analysis. Am J Chin Med. 2019;47(8):1755–80.
[20] Linde K, Allais G, Brinkhaus B, , et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6):CD001218.
[21] Li K, Zhang Y, Ning Y, et al. The effects of acupuncture treatment on the right frontoparietal network in migraine without aura patients. J Headache Pain. 2015;16:33.


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