TCM for Headache and Migraine: Evidence by Intervention
What Cochrane reviews and other studies found for acupuncture and Chinese herbs used for migraine prevention and tension-type headache, with safety notes and when to get care first.
Content last updated . This page has not been medically reviewed.
Get checked first if the headache is new or different
A headache that comes on suddenly and is extremely painful needs emergency care. [1] The same goes for a headache with drowsiness or confusion, a seizure, a very high temperature with signs of meningitis, weakness on one side of the body or face, or a recent head injury. [1] In the United States call 911. Ask for an urgent appointment if a migraine lasts more than 72 hours, aura symptoms last longer than an hour, or you are pregnant or just had a baby. [1] See a clinician if attacks are severe, getting worse or happen more than once a week. [1] (These lists come from the UK NHS; emergency numbers differ by country.)What the research can and cannot tell us
Migraine and tension-type headache are common, come and go, and respond to expectation, so good trials need a comparison group. This page reports what studies of specific treatments found. It does not test traditional explanations such as "wind" or "liver" patterns, which are described on Traditional Pattern Differentiation in TCM.| Treatment and use | What the sources found | Label |
|---|---|---|
| Acupuncture to prevent episodic migraine | A 2016 Cochrane review of 22 trials (4,985 people) found a moderate reduction in headache frequency versus no acupuncture, and a small effect over sham needling. [2] It also found acupuncture may be at least similarly effective as preventive drugs, with fewer side effects, but long-term studies beyond a year are lacking. [2] | Promising to established; effect over sham is small |
| Acupuncture compared with standard medical care for migraine prevention | A 2025 review of 15 studies found no significant difference in migraine days or pain intensity, but less analgesic use and better quality of life, and called it adjunctive. [3] | Mixed |
| Acupuncture to prevent tension-type headache | A 2016 Cochrane review of 12 trials (2,349 people): 51% had at least a halving of headache frequency with acupuncture versus 43% with sham. [4] | Promising but limited |
| Oral Chinese herbal medicine for migraine versus placebo | A review of 18 trials (3,015 people) found fewer migraines and less pain than placebo, with comparable adverse events and moderate certainty. [5] | Promising but limited |
| Oral Chinese herbal medicine versus flunarizine (a preventive drug) | A review of 35 trials (2,840 people) found herbs comparable or better, but certainty was low or very low. [6] | Insufficient evidence |
| Massage for migraine | NCCIH says limited evidence from two small studies suggests it is possibly helpful. [7] | Insufficient evidence |
| Tai chi for tension headache | NCCIH says one small study's data are too limited to draw meaningful conclusions. [7] | Insufficient evidence |
How to read the acupuncture results
NCCIH sums up the combined acupuncture studies this way: acupuncture may help relieve headache pain, but much of the benefit may come from expectation, beliefs and placebo responses rather than specific effects of needling. [7] Cochrane's migraine authors reached a similar picture: some real effect beyond sham, but small. [2] The NHS lists acupuncture among preventive options for migraine alongside medicines, relaxation techniques and cognitive behavioral therapy (CBT). [1] For needling details and migraine-specific results, see Acupuncture for Migraine Prevention and Tension-Type Headaches.How to read the herb results
The herb reviews pool mostly Chinese trials, and some reviews rated the certainty of the evidence low or very low. [6] NCCIH notes that many studies of Chinese herbal products have been of poor quality, so no firm conclusions can be made. [8] Review authors point to herb pairs containing Chuan Xiong as a lead for future research, but this is a hypothesis, not a recommendation. [6] Some Chinese herbal products have been contaminated with toxic compounds, heavy metals, pesticides and microorganisms. [8] Read Chinese Herbal Products: Quality, Contamination and Medicine Interactions before buying any.Frequently asked questions
Does acupuncture work for migraine?
Cochrane found it reduces migraine frequency more than no acupuncture and slightly more than sham, with effects that may be at least comparable to preventive drugs. [2]
Can Chinese herbs prevent migraines?
A review of 18 trials found oral Chinese herbs beat placebo, but NCCIH cautions that many herbal studies are of poor quality. [5] [8]
Is acupuncture just a placebo for headaches?
NCCIH says much of the benefit may be nonspecific, such as expectation, rather than from needling itself. [7]
Can I use TCM instead of my migraine medicine?
Do not stop prescribed treatment on your own. Talk with your clinician about adding any approach. [8]
What if my headache is sudden and severe?
Treat it as an emergency and seek care immediately. [1]
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
Acupuncture delivered properly by a trained practitioner is generally considered safe; improper delivery can cause serious harm. [7] If you take migraine or other prescribed medicines, tell your prescriber and pharmacist about any herb, since herbs and medicines can interact. [8] See Chinese Herbs and Prescription Medicines.
References
- National Health Service (NHS, UK), Migraine: treatment. Read 2026-10-22.
- Linde K et al. Acupuncture for the prevention of episodic migraine. The Cochrane database of systematic reviews 2016. PubMed 27351677. Read 2026-10-22.
- Pistoia F et al. Acupuncture Versus Standard Medical Care in the Prophylactic Treatment of Migraine: A Systematic Review and Meta-Analysis. European journal of neurology 2025. PubMed 40237227. Read 2026-10-22.
- Linde K et al. Acupuncture for the prevention of tension-type headache. The Cochrane database of systematic reviews 2016. PubMed 27092807. Read 2026-10-22.
- Lyu S et al. Efficacy and Safety of Oral Chinese Herbal Medicine for Migraine: A Systematic Review and Meta-Analyses Using Robust Variance Estimation Model. Frontiers in neurology 2022. PubMed 35873759. Read 2026-10-22.
- Lyu S et al. Oral Chinese Herbal Medicine as Prophylactic Treatment for Episodic Migraine in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-based complementary and alternative medicine : eCAM 2020. PubMed 33424985. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Headaches: In Depth. Read 2026-10-22.
- National Center for Complementary and Integrative Health (NCCIH, US), Traditional Chinese Medicine: What You Need To Know. 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.