Acupuncture as an Effective Alternative to Medication for Migraine — What the Latest Umbrella Review Says

Migraine is a highly common and often disabling headache disorder that affects millions of people worldwide, sometimes severely impairing quality of life. The search for effective, safe, and tolerable treatments is ongoing — and recently, attention has turned back to a traditional approach: acupuncture. A new umbrella review argues that acupuncture may be a viable alternative to conventional medication for migraine.

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What was studied?

The review — Acupuncture is an effective alternative to medication for migraine: An umbrella review — examined evidence from systematic reviews (with or without meta-analyses) of randomized controlled trials that directly compared acupuncture to standard pharmacological (drug-based) treatments for migraine. Studies included patients of all ages with episodic or chronic migraine, with or without aura.

Key outcomes assessed were:

• Pain intensity (how severe the migraine pain is)
• Number of migraine days per month
• Response rate, quality of life, dropout rates, use of rescue medication, and adverse events (side effects)

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What did they find?

• The review included 22 systematic reviews, covering 24,635 patients in total.
• In pooled analyses, patients who received acupuncture — compared with those receiving medication — experienced a statistically significant reduction in pain intensity (standard mean difference, SMD: –2.17; 95% confidence interval (CI): –3.25 to –1.10; P < 0.001).
• They also had fewer migraine days per month (SMD: –2.92; 95% CI: –4.65 to –1.20; P < 0.001).
• Subgroup analyses indicated that these benefits persisted up to three months after the end of acupuncture treatment.
• On other outcomes — such as response rate, use of rescue medication, dropout rate, or adverse events — the evidence did not reach statistical significance.
• The authors note, however, that the methodological quality of the included reviews ranged from low to moderate, and there was a moderate degree of overlap among the included reviews.

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What does this mean — and what doesn’t it?

What it suggests:

• Acupuncture appears to offer a meaningful reduction in migraine pain and frequency, comparable or even superior to medication — especially for those seeking non-pharmacological alternatives.
• Because acupuncture is generally considered safe and has a different side-effect profile than many migraine drugs, it can be an attractive option for people who don’t tolerate medications well, have contraindications, or simply prefer “natural” or integrative approaches.

What we should be cautious about:

• The underlying evidence is heterogeneous: the included reviews vary in quality, and the overlap among them reduces the certainty of the conclusions.
• Key outcomes beyond pain and frequency — such as long-term effectiveness, relapse rates, and side-effect profiles versus medication — remain underexplored or inconclusive.
• Acupuncture quality matters (technique, frequency, practitioner experience), but this review can’t fully account for variability between studies.

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Who might benefit most from acupuncture — according to the authors

The review’s authors suggest that acupuncture may be especially appropriate when:

• Conventional migraine medications are ineffective, not well tolerated, or contraindicated,
• Patients prefer non-pharmacological treatments,
• Preventive therapy is desired (i.e., reducing the frequency/intensity of migraines rather than just treating attacks).

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Final thoughts

The growing body of evidence compiled in this umbrella review points toward acupuncture being more than just a complementary therapy — it may be a genuine, evidence-supported alternative to standard migraine medications, at least for some patients. That said, due to limitations in the data, acupuncture should not yet be considered a replacement for conventional treatments in all cases, but rather a viable option in a broader migraine management plan.

For individuals seeking safer, integrative, or preventive migraine care, discussing acupuncture with a healthcare provider — perhaps as part of a multi-modal treatment strategy — may be worthwhile.

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References —

1. Pereira PA, Marto CM, Oliveiros B, Botelho MF. Acupuncture is an effective alternative to medication for migraine: An umbrella review. J Integr Med. 2025 Oct 13:S2095-4964(25)00162-1. doi: 10.1016/j.joim.2025.10.003. Epub ahead of print. PMID: 41350152. (link)