Acupuncture for Migraine

Migraine sufferers and their doctors are always looking for effective medical and non-medical ways to manage migraine headaches. Because migraine is not typically considered a dangerous condition, safety is an essential component of prospective migraine treatments.

Migraine patients look towards complementary therapies such as acupuncture particularly for prevention. Often, patients self-refer to acupuncturists or ask their doctors for recommendations. Some neurologists and other doctors who specialize in headaches either refer patients to acupuncturists for intervention or have learned how to perform the outpatient procedures themselves in the office.

Effectiveness is, of course, an important consideration for patients who must self-pay for the procedure, as it is for third party payers who determine whether or not they will cover the cost of acupuncture.

Acupuncture and short-term efficacy for migraine prevention

A relatively large multi-center single blinded randomized controlled trial in China involved 480 migraine patients. The patients were assigned either to an acupuncture group or to a sham acupuncture group for a total of 20 treatments over the course of 4 weeks. The patients in the treatment group had acupuncture intervention with needles placed at migraine specific points. Patients who received the real acupuncture treatment reported fewer days with migraine at weeks 5-8 and at weeks 13-16 after the study was completed. This result was in line with most short-term acupuncture/migraine trails, the majority of which included fewer patients than this large study.

Acupuncture's long-term efficacy for migraine prevention

Another, more recent, smaller study in Australia involved only 50 migraine patients, who were divided into a real acupuncture group and a sham acupuncture group. This study, however, lasted longer, with a treatment period of 20 weeks and follow up for a year. The effectiveness of acupuncture was indeed significant at the three-month mark, but effectiveness in migraine reduction did not last for the whole year. There are many possible explanations for this finding, including a short-term duration of treatment or a relatively fleeting placebo effect.

Safety of acupuncture for migraine

Overall, studies have shown some efficacy of acupuncture, and have been consistent in terms of patient safety. Of course, a treatment such as acupuncture leaves patients vulnerable to a placebo effect. But placebo effect can also play a role in the increased reporting of adverse reactions, which does not seem to be a big part of acupuncture therapy.

Pros and cons of acupuncture for migraine

There are a few pros and cons to the idea of acupuncture for migraine. On the pro side, most importantly, the safety profile is a positive. On the negative side, the inconsistency of payer coverage can make acupuncture costly for some patients. The short-term efficacy may also make repeated procedures necessary, and some patients may experience shifting responsiveness to the therapy with repeated intervention (improving or declining response.)

Overall, acupuncture for migraine is a preventative therapeutic approach that does not appear to interact with preventative pharmaceuticals for migraine or with the powerful migraine treatments that are generally used during a migraine.

Would you refer your migraine patients for acupuncture? Would you consider learning how to do acupuncture for your patients?

References:

Da Silva AN. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-473.

Li Y, et al. Acupuncture for migraine prophylaxis: a randomized controlled trial. CMAJ. 2012 Mar 6;184(4):401-410.

Wang Y, et al. Acupuncture for frequent migraine: a randomized, patient/assessor blinded, controlled trial with one-year follow-up. Evid Based Complement Alternat Med. 2015;2015:920353.