Migraine brings symptoms such as a severe headache, feeling sick and sensitivity to light. Alongside medicines and relaxation techniques, the NHS lists acupuncture as one of the options for helping to prevent migraine attacks. So what is that based on? The most thorough summary is a Cochrane review from 2016.
The review
"Acupuncture for the prevention of episodic migraine" was published in June 2016 by Linde and colleagues. They gathered 22 randomised trials involving 4,985 people, with searches running to January 2016.
The main question was simple. After a course of acupuncture, how many people had their number of migraine days cut by at least half?
Compared with usual care
Four trials added acupuncture to people's usual treatment for attacks and compared them with people who had usual treatment alone.
- With acupuncture: 41 in every 100 people had their headache frequency halved
- Without: 17 in every 100
That amounts to a moderate reduction in headache frequency, based on moderate-quality evidence.
Compared with sham acupuncture
Fifteen trials compared real acupuncture with sham (fake) acupuncture. After treatment, 50 in 100 people improved this much with real acupuncture, against 41 in 100 with sham. At later follow-up the figures were 53 and 42 in 100.
The authors called this "a small but statistically significant" difference. Put another way, a lot of the improvement people see also happens with sham treatment. That suggests the overall experience of care plays a big part, as well as anything specific to where the needles go.
Compared with preventive medicines
Five trials compared acupuncture with preventive drugs, and three of these gave usable data. At three months, 57 in 100 people had their migraine frequency halved with acupuncture, compared with 46 in 100 on medication. By six months the gap had narrowed to 59 and 54 in 100. People having acupuncture reported fewer side effects and were less likely to drop out of treatment.
That's only a handful of trials, so treat this comparison with some caution. The authors' own wording is cautious. They say acupuncture "may be at least similarly effective" as preventive drugs, not that it's clearly better.
What the authors concluded
Overall they rated the evidence as moderate quality. In their view "a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with migraine", and it "can be considered a treatment option for patients willing to undergo this treatment". They also noted that, as for other migraine treatments, studies lasting more than a year are lacking.
Where NICE stands
The headache guideline (CG150, updated in June 2025) covers people for whom propranolol, topiramate and amitriptyline have not worked, are not tolerated or are unsuitable. For them, clinicians should consider "a course of up to 10 sessions of acupuncture over 5 to 8 weeks according to the person's preference, comorbidities and risk of adverse events".
Keep your GP in the loop
See a GP if your migraine attacks are severe or getting worse, happen more than once a week, or are hard to control. A headache that comes on suddenly and is extremely painful, or comes with problems speaking, vision loss or confusion, needs emergency help. Acupuncture works best as part of your wider care, not instead of it.
If you'd like to talk about whether a course of acupuncture might suit you, you can get in touch with me.
I've also written a dedicated page on acupuncture for migraine, with what a session involves.