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THERAPIES & TRADITIONS · GUIDE

Acupuncture for Migraine Prevention and Tension-Type Headaches

What Cochrane reviews, NICE and NCCIH say about acupuncture for preventing migraine and tension-type headache, including the size of the benefit over sham and over preventive drugs.

Content last updated . This page has not been medically reviewed.

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Urgent signs first

Some headaches need prompt medical assessment. NICE tells clinicians to consider investigation or referral for a worsening headache with fever, [1] a sudden-onset headache reaching maximum intensity within 5 minutes, or a new neurological deficit. [1] In the United States, call 911 in an emergency. Get these signs assessed before considering acupuncture.

The short answer

Acupuncture has been studied mainly as a way to prevent headaches, not to stop one that has started. Cochrane reviews found a small benefit over sham acupuncture for frequent migraine and for tension-type headache, and a larger one over no preventive treatment. NICE says acupuncture may be considered in specific situations. Evidence label: promising but limited. For background, see what is acupuncture.

Migraine prevention

A 2016 Cochrane review pooled 22 trials with 4,985 people. [2]
  • Against no acupuncture. Headache frequency was at least halved in 41 percent of those given acupuncture and 17 percent of those given none. [2] These trials could not be blinded, which can inflate benefit. [2]
  • Against sham. Acupuncture was associated with a small but statistically significant reduction in frequency (moderate-quality evidence). [2] Frequency was at least halved in 50 percent of the acupuncture group and 41 percent of the sham group. [2]
  • Against preventive drugs. Acupuncture reduced migraine frequency significantly more than drug prophylaxis right after treatment, [2] but the difference was not maintained at follow-up. [2] People on acupuncture were less likely to drop out because of adverse effects. [2]

NCCIH adds that much of the benefit may be due to expectation, beliefs and placebo responses rather than needling itself. [3]

Tension-type headache

A 2016 Cochrane review included 12 trials with 2,349 people. [4]
  • Against routine care or acute-only treatment. Two large trials were not blinded, though otherwise high quality, and many more people reached a 50 percent drop in headache frequency with acupuncture. [4]
  • Against sham. 205 of 391 (51 percent) reached at least a 50 percent reduction versus 133 of 312 (43 percent) with sham. [4]
  • Against physiotherapy, massage or exercise. No trial found acupuncture significantly better. [4]

What guidelines say

NICE (headaches in over 12s, updated June 2025) says to consider a course of up to 10 sessions of acupuncture over 5 to 8 weeks to prevent chronic tension-type headache. [1] For migraine prevention it says to consider a similar course if propranolol, topiramate and amitriptyline have not worked or are not suitable, [1] depending on the person's preference, other conditions and risk of adverse events. [1] The NHS says it may offer acupuncture for migraine-type headaches. [5]

Evidence summary

5 findings · 3 supported · 2 limited or unclearThe colour follows the evidence label on each card.

  1. Migraine prevention vs sham

    Promising but limited

    Small frequency reduction [2]

  2. Migraine prevention vs drugs

    Promising but limited

    Better right after treatment, not significantly at follow-up [2]

  3. Tension-type prevention vs sham

    Promising but limited

    51% vs 43% reached a 50% drop [4]

  4. Stopping a migraine attack

    Insufficient evidence

    Proper evidence not found in the sources we read

  5. Cluster headache, medication-overuse headache, children

    Insufficient evidence

    Proper evidence not found in the sources we read

Frequently asked questions

Does acupuncture prevent migraines?

It reduced frequency a little more than sham and more than no treatment in a Cochrane review. [2]

Is acupuncture better than migraine drugs?

It was better right after treatment with fewer dropouts from side effects, but not significantly at follow-up. [2] Do not stop a prescribed medicine without talking to your clinician.

Does it help tension headaches?

A Cochrane review found a modest advantage over sham and a larger one over routine care. [4]

How many sessions does NICE mention?

Up to 10 sessions over 5 to 8 weeks, when acupuncture is considered. [1] Your own plan may differ.

Can acupuncture treat a migraine that has already started?

We found no source we could read showing this, so we do not make that claim.

More details: evidence, limits and cautions

The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.

Safety
NCCIH warns that poorly delivered acupuncture can cause infections, punctured organs and injury to the central nervous system. [6] The NHS says acupuncture may not be safe if you take blood-thinning medicine or are at increased risk of bleeding. [5] See side effects and precautions. For acupressure approaches, see acupressure for headache and pain. To prepare for a visit, read the first appointment guide.
References
  1. NICE, Headaches in over 12s: diagnosis and management (CG150), last updated 3 June 2025. Read 2026-10-22.
  2. Linde K, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016;(6):CD001218. PubMed 27351677 Read 2026-10-22.
  3. NCCIH, Headaches: What the Science Says. Read 2026-10-22.
  4. Linde K, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587. PubMed 27092807 Read 2026-10-22.
  5. NHS, Herbal medicines and complementary therapies. Read 2026-10-22.
  6. NCCIH, Acupuncture: Effectiveness and Safety. Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.