In short
- For migraine, acupuncture is used as a preventive treatment: to reduce how often attacks happen, not to abort one that has started.
- Evidence is reasonably supportive for migraine prevention and for tension-type headache.
- A preventive course usually runs six to ten sessions before its effect can be judged.
- Keep a headache diary from the first session; it is the only reliable way to tell whether anything changed.
Migraine and tension-type headache are different problems
Tension-type headache is typically a dull, pressing, band-like pain on both sides of the head, usually mild to moderate, not made dramatically worse by routine activity. Migraine is usually one-sided, throbbing, moderate to severe, often with nausea and sensitivity to light or sound, and often made worse by movement. Some people get both.
The distinction matters because the treatment logic differs. Acupuncture for tension-type headache often addresses muscular and postural contributors directly. For migraine it is used the way a preventive medication is used: a course of treatment intended to reduce the frequency and severity of future attacks.
What the evidence shows
Migraine prevention is one of the areas where acupuncture has been studied most carefully. Reviews of that literature generally find that a course of acupuncture reduces the number of headache days compared with no preventive treatment, and performs at least comparably to some preventive medications, with fewer side effects.
For tension-type headache, the evidence also leans positive, particularly for frequent or chronic presentations.
As with pain generally, the realistic goal is fewer and less severe attacks, not the end of migraine. People who track their headache days before and during treatment are in a much better position to judge whether it is working.
Acupuncture sits alongside medical care, not in place of it. If a symptom is new, severe, or changing quickly, or if you have been given a diagnosis you are still working through with a physician: keep that care going and tell your acupuncturist about it.
What a course looks like
Because the aim is prevention, the course is front-loaded: commonly one to two sessions a week for several weeks, then a review. Six to ten sessions is a typical window before judging the result. If attacks are less frequent, sessions are usually spaced out gradually.
Keep taking any preventive or acute migraine medication you have been prescribed unless the prescribing physician says otherwise. Acupuncture is often used alongside medication rather than instead of it.
Keep a headache diary
Memory is unreliable for something as episodic as migraine. A simple diary makes the difference between knowing and guessing, and most practitioners will ask for one.
- The date and rough duration of each attack.
- Severity, on a simple one-to-ten scale.
- Any acute medication taken, and whether it worked.
- Likely triggers: missed meals, poor sleep, alcohol, screen time, menstrual cycle.
- How many days in the month were headache-free.
Headaches that need a doctor, not an acupuncturist
Most headaches are not dangerous, but a few patterns need urgent medical assessment. Seek care immediately for a headache that comes on suddenly and reaches maximum intensity within seconds or minutes, a headache following a head injury, or a headache with fever and a stiff neck, confusion, weakness, visual loss, or a first severe headache after about age 50. A headache that is clearly different from your usual pattern also warrants a medical opinion.
Questions worth asking a practitioner
- How many migraine patients do you treat, and do you treat for prevention or for acute attacks?
- How many sessions before we review whether this is working?
- Will you want to see a headache diary?
- Do you coordinate with my neurologist or primary care physician?