Acupuncture for Migraines

Acupuncture is increasingly being researched as a preventive treatment option for migraines. Scientific studies and international guidelines conclude that acupuncture can be an effective alternative or complement to medication prophylaxis for some patients, particularly when medications have insufficient effect or cause side effects. Research distinguishes between episodic and chronic migraines. The number of days a person experiences headaches is particularly significant: in chronic migraine, this is at least 15 days per month for a minimum of 3 consecutive months. Episodic migraine is more variable and can sporadically lead to attacks. Each attack of episodic migraine must meet migraine criteria, while in chronic migraine, migraine symptoms must occur on at least 8 of the 15 days.

Research
A systematic review by the independent research institute Cochrane concludes that acupuncture may be at least as effective as standard prophylactic medication in preventing episodic migraines [1]. This positions acupuncture as a viable treatment option for patients who are open to it.

A recent meta-analysis in the Journal of Pain Research (2025) directly compared acupuncture with pharmacological prophylaxis, including flunarizine, metoprolol, and topiramate, in patients with chronic migraines.
[2]. The results showed that acupuncture yielded better outcomes in terms of attack frequency and severity, with fewer side effects.

The authors rightly note a caveat regarding the quality of the evidence, which was rated as moderate to low due to heterogeneity and methodological limitations. Nevertheless, they consider the observed effects clinically relevant, particularly for patients who do not benefit sufficiently from medication treatment.

Side Effects and Safety
Acupuncture is generally well tolerated for migraines as well. Serious side effects are rare, and mild complaints such as temporary fatigue or minor bruising occur sporadically. Safety analyses confirm that acupuncture, performed by a well-trained practitioner, is a safe intervention [3].

Medical Guidelines
The British National Institute for Health and Care Excellence (NICE) recommends a series of up to ten acupuncture sessions within five to eight weeks for the treatment of tension-type headaches and migraines with aura when medications such as topiramate or propranolol are insufficiently effective [4].

Cochrane states in its review that acupuncture may be considered as a preventive treatment option for migraine patients who wish to pursue this form of therapy [1].

Acupuncture within Responsible Care
According to the KNMG, non-conventional treatment methods can be applied within conventional care, provided that conditions such as safety, transparency, and good information provision are met [5]. Based on current scientific evidence and clinical experience, acupuncture can be discussed as a possible and safe preventive treatment for migraines, in addition to conventional treatment options.

References - Migraine

Cohrane, Acupuncture for preventing migraine attacks, Cochrane Review, published online, 2016 (June)
https://www.cochrane.org/CD001...[←].
Liu, A.R. et al, Efficacy of Acupuncture and Pharmacotherapy for Migraine Prophylaxis: A Systematic Review and Meta-Analysis, Journal of Pain Research, 2025 (May), Vol. 2025:18, pp. 2521—2540,
https://doi.org/10.2147/JPR.S5....
Evidence Based Acupuncture, Summary - Research on Acupuncture Safety, 2021 (July) https://www.evidencebasedacupuncture.org/safety/[←].
National Institute for Health and Care Excellence (NICE), Headaches in over 12s: diagnosis and management, NICE Clinical guideline [CG150], 2012 (Sept), Updated 2021 (May) https://www.nice.org.uk/guidan...[←].
Doctors' Federation KNMG, Advisory Guidelines for Non-Regular Treatment Methods
https://www.knmg.nl/advies-ric...[←].