Acupuncture is a traditional therapy that involves inserting fine needles into specific body points to modulate pain and physiological function. It’s used both for acute and preventive migraine treatment

🧠 Biological Plausibility

Rating: Good (2.5 / 3)
Explanation:
Acupuncture triggers a cascade of neurophysiological effects that align with known migraine mechanisms. These include activation of descending pain-inhibitory circuits, reduced CGRP release from trigeminal afferents, suppression of neuroinflammation, and modulation of vagal tone. Importantly, these effects persist in animal models and under anesthesia, making a purely placebo-based explanation unlikely.

πŸ”¬ Evidence

Rating: Moderate
Multiple sham-controlled RCTs and meta-analyses show a small but consistent preventive effect over sham, and a stronger effect versus usual care or waitlist. Strongest effects occur with β‰₯6 sessions over 3–6 weeks.

🎯 Effect Size

Rating: Low
Typical benefit: ~1–1.5 fewer migraine days per month. Around 15–20% more patients achieve β‰₯50% reduction compared to sham. Some evidence suggests effects last weeks to months after treatment ends, especially with regular booster sessions.

⚠️ Risk

Rating: Low
Minor risks include transient bleeding or bruising. Serious adverse events (infection, nerve injury) are extremely rare when done by trained professionals.

πŸ’° Cost

Rating: $$
A course of acupuncture typically ranges from $60–$120 per session, with 6–10 sessions recommended. Some insurance plans cover treatment.

πŸ“Š Scores

  • Benefit: 2
  • Burden: 4
  • SCORE: 0.50

πŸ” Clinical Takeaways

  • Best suited for people interested in drug-free or complementary treatments.
  • Especially helpful when used preventively with regular sessions.
  • Choose a licensed provider with migraine experience.

πŸ“š Key References

  • Linde K, et al. Acupuncture for the prevention of tension-type headache and migraine. Cochrane Review, 2016.
  • Zhao L, et al. Long-term effect of acupuncture for migraine prophylaxis: a randomized clinical trial. JAMA Intern Med, 2017.
  • Napadow V, et al. The brain circuitry underlying the anti-nociceptive effects of acupuncture. Neuroimage, 2009.

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