Recent studies have reaffirmed acupuncture’s efficacy in the treatment and management of migraines, highlighting both its clinical benefits and specific methodologies. This article focuses on the techniques and procedures that licensed acupuncturists use, offering a scientifically rigorous overview of recent findings.
Clinical Findings on Acupuncture for Migraines
A recent randomized controlled trial (RCT) explored the effectiveness of acupuncture compared to both sham acupuncture and conventional drug therapy in managing chronic migraines. The study found that acupuncture significantly reduced the frequency and intensity of migraine attacks, leading to improvements in patients’ quality of life. Specifically, the reduction in pain was attributed to the use of specific acupoints, such as GB20 (Fengchi), LI4 (Hegu), ST36 (Zusanli), and SP6 (Sanyinjiao). Patients treated with acupuncture experienced a notable decrease in the Visual Analog Scale (VAS) scores for pain, as well as improvements in the Migraine-Specific Quality of Life (MSQ) scores when compared to those receiving conventional drug treatments. [1] [2]
Acupuncture Procedures and Techniques
The study employed 0.25 mm x 40 mm needles inserted to a depth of 10-20 mm, depending on the targeted acupoint and the patient’s body type. Needle retention time was 30 minutes per session, with mild manual manipulation to achieve a deqi sensation—a characteristic tingling or heavy feeling that is considered a sign of effective stimulation. The treatments were administered twice weekly for 8 weeks, a frequency found to optimize therapeutic effects for chronic migraines. [2]
Electroacupuncture for Enhanced Results
In addition to manual acupuncture, electroacupuncture (EA) was employed in several trials, showing enhanced efficacy in modulating pain pathways. EA was particularly effective in regulating the activity of calcitonin gene-related peptide (CGRP), a neuropeptide involved in migraine pathophysiology. In one trial, 2 Hz stimulation was applied using electrodes connected to needles inserted at LI4 and ST36. The treatment lasted 30 minutes per session, administered three times per week for four weeks. This approach led to a reduction in CGRP levels in both plasma and dura mater, as well as reduced activation of trigeminal nerve pathways, which are known to play a key role in migraine pathogenesis. [2]
Mechanisms and Biomedical Outcomes
Acupuncture’s efficacy in migraine treatment has been linked to several mechanisms, including the modulation of the trigeminal sensory pathway and the inhibition of inflammatory mediators. Studies have demonstrated that acupuncture reduces levels of inflammatory markers such as matrix metalloproteinase-2 (MMP-2), which is elevated during migraine attacks. Additionally, EA has been shown to reduce hyperalgesia by decreasing the levels of c-Fos in trigeminal ganglia, indicating a downregulation of nociceptive processing. [1] [2]
MRI studies further support these findings, showing increased activity in pain-regulating areas of the brain, including the prefrontal cortex and insular cortex, following acupuncture treatments. These changes correlate with improved subjective pain ratings, suggesting that acupuncture not only alleviates the symptoms of migraines but may also address underlying neurophysiological dysfunctions associated with chronic pain. [2]
Practical Application: Treatment Protocols
Based on the research, the following treatment protocol serves as a guide:
• Acupoints: GB20, LI4, ST36, SP6.
• Needle Specifications: 0.25 mm x 40 mm needles.
• Insertion Depth: 10-20 mm based on patient body type.
• Retention Time: 30 minutes.
• Technique: Manual manipulation to induce deqi sensation.
• Frequency: 2-3 sessions per week for 8-12 weeks, depending on patient response.
For those using electroacupuncture, attaching electrodes to needles at LI4 and ST36 with 2 Hz stimulation for 30 minutes per session has been shown to be particularly effective in reducing migraine frequency and intensity. It is important to monitor patient comfort closely, as the deqi sensation may vary with electrical stimulation.
Here is a short video on the overall topic:
Conclusion
The recent findings highlight acupuncture as a viable and effective non-pharmacological treatment for chronic migraines, with fewer side effects compared to conventional medications. By targeting specific neurophysiological pathways and reducing inflammation, acupuncture offers both symptomatic relief and potential long-term benefits for migraine patients. These studies provide a detailed roadmap for practitioners, emphasizing the importance of precise needle technique, acupoint selection, and treatment frequency for achieving optimal outcomes.
Sources
1. “Efficacy of acupuncture-related therapy for migraine,” Journal of Pain Research, 2024.
2. “Effects of acupuncture on mental health of migraine patients: a systematic review and meta-analysis,” BMC Complementary Medicine and Therapies, 2024.
