A case series published in Neurological Sciences demonstrates that acupuncture is as an effective preventive treatment for cluster headaches (CH), with all four patients in the study experiencing complete cessation of attacks following treatment [1]. This report, while limited in scope, provides important clinical details that can inform best practices for licensed acupuncturists seeking to treat CH with acupuncture.
The prospective case series focused on four individuals diagnosed with episodic cluster headaches according to the International Headache Society (IHS) criteria. Two patients were administered acupuncture as a standalone therapy, while the other two combined acupuncture with verapamil, a calcium channel blocker commonly used as a first-line prophylactic drug for CH [1].
Each patient received acupuncture over a structured 12-week period. Treatments were administered twice weekly for the first two weeks, once weekly for the following eight weeks, and biweekly for the final two weeks. All sessions lasted approximately 20 minutes, with manual needle stimulation used to elicit the deqi sensation upon insertion [1].
The acupoints selected were consistent across the four patients and based on traditional Chinese medicine (TCM) meridian theory. Local points on the affected side included Ex-HN5 (Taiyang) and GB14 (Yangbai), chosen for their proximity to the orbital and trigeminal distribution associated with CH symptomatology. In addition, bilateral systemic points were used to modulate underlying constitutional patterns believed to contribute to CH pathogenesis. These included GB20 (Fengchi), LI4 (Hegu), LV2 (Xingjian), SP6 (Sanyinjiao), and ST36 (Zusanli) [1]. Enjoy HealthCMi on-demand acpuncture CEU-PDA courses online and webinars to learn more about the treatment of headaches, migraines, and cluster headaches. View Courses >
Needles were inserted perpendicularly or obliquely to a depth sufficient to elicit deqi, then retained without further stimulation. No electrical stimulation was used in this protocol, and needle retention time was uniformly 20 minutes [1].
The outcomes were notably positive. All patients reported complete remission of cluster attacks during and after the treatment period, and no adverse events were recorded. This includes both patients treated solely with acupuncture and those who also continued pharmacologic therapy. Subjective reports indicated improved sleep quality and mood stabilization in some cases, though these secondary outcomes were not the primary focus of the study [1].
While the small sample size limits the generalizability of the findings, the consistent positive outcomes across all cases provide support for further investigation into acupuncture as a CH preventive modality. Moreover, the reproducibility of the treatment protocol—including frequency, acupoint selection, and manual needle technique—adds value for practitioners who wish to implement similar approaches in clinical practice.
Licensed acupuncturists at HealthCMi note that the acupoint prescription used in the research aligns with both contemporary clinical practice and traditional meridian theory. The HealthCMi team further recommends considering the inclusion of points such as GV24 (Shenting), Sishencong, auricular Shenmen, LV3 (Taichong), and TB5 (Waiguan), as well as other points commonly indicated for the treatment of cluster headaches.
The use of acupoints such as GB20 and LI4, often associated with neuromodulatory effects, suggests a plausible mechanism of action involving central nervous system regulation. Local points like Taiyang and Yangbai may modulate periorbital pain by acting on trigeminal and facial nerve branches. However, the study did not include MRI or serum biomarker analyses to validate neurochemical or inflammatory mechanisms of action. Future trials incorporating these metrics could clarify the biological basis for acupuncture’s effect on CH [1].
From a clinical standpoint, this report supports a consistent, well-structured acupuncture protocol for CH, using both local and distal points grounded in TCM diagnosis. For practitioners, key takeaways include the value of early intervention in the cluster cycle, the importance of point selection based on meridian correspondence, and the efficacy of manual needling techniques in achieving therapeutic outcomes.
In conclusion, this study adds to the small but growing body of literature suggesting acupuncture may be a viable, low-risk option for CH prevention. Given the often intractable and disabling nature of cluster headaches, acupuncture may offer an effective adjunct or alternative for patients with contraindications to standard prophylactic pharmacotherapy. However, large-scale randomized controlled trials are necessary to confirm these findings and elucidate acupuncture’s mechanistic underpinnings in CH management.
Source
1. L. Fofi, G. Allais, P. E. Quirico, S. Rolando, P. Borgogno, P. Barbanti, and C. Benedetto, “Acupuncture in cluster headache: four cases and review of the literature,” Neurological Sciences 35, no. S1 (2014): 195–198.
