Acupuncture Helpful for Acute, Preventive Treatment of Migraine but Higher Quality Evidence Needed

hand of acupuncturist putting needles into womans forehead
hand of acupuncturist putting needles into womans forehead

Based on a review of current research literature, acupuncture can improve pain of acute migraines and can be used as a preventive treatment for migraines, but the quality of systematic reviews and meta-analysis are less than ideal, according to a study published in Pain Research and Management.

The aim of this study was to assess systematic reviews and meta-analyses to evaluate the efficacy of acupuncture on pain and prevention of migraines. For systematic reviews and meta-analyses to be included, they had to include randomized controlled trials, all migraines needed to be diagnosed using internationally accepted clinical guidelines, the intervention had to include acupuncture techniques, and the control had to include blanks, placebos, drugs, or other treatments. The outcomes of interest included pain intensity, usages of rescue analgesics, severe events, and frequency of migraine attacks. The databases searched were PubMed, Excerpta Medica database (Embase), the Cochrane Library, China Knowledge Resource Integrated Database, VIP Chinese Journal Full Text Database, WANFANG Data, and China Biology Medicine.

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Of the 15 systematic reviews and meta-analyses included in this study, 13 included patients with migraine, 1 included patients with episodic migraine, and 1 included patients with menstrual migraines. Overall, only 4 studies were reviewed by Grading of Recommendations, Assessment, Development, and Evaluations, and no studies met methodological quality according to A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2), with 14 rating critically low.

In summary of the main findings, acupuncture was superior to drug treatments in 6 trials, acupuncture was superior to sham acupuncture and drugs in 4 trials, acupuncture was superior to sham acupuncture in 3 trials, acupuncture was superior to drugs and other treatments in 1 trial, and acupuncture was superior in 1 other unspecified trial.

Limitations of this study include the low quality of the systematic reviews and meta-analysis and the potential for conflict of interest of the randomized clinical trials included in this analysis.

The researchers concluded that “acupuncture has the advantage for acute and preventive treatment of migraine in pain improvement and safety, but the quality of [systematic reviews and meta-analysis] of acupuncture for migraine still needs to be improved.”


Zhang XT, Li XY, Zhao C, et al. An overview of systematic reviews of randomized controlled trials on acupuncture treating migraine [published online October 29, 2019]. Pain Res Manag. doi:10.1155/2019/5930627