Acupuncture for acute treatment of migraine without aura: A randomized clinical trial

This study aimed to evaluate the immediate analgesic efficacy of acupuncture in acute migraine without aura.

Patients with acute migraine without aura require prompt relief from headache. Acupuncture has the potential to provide rapid pain relief; however, its analgesic efficacy warrants further validation.

We designed a single-blind, sham-controlled, randomized controlled trial and randomly allocated 80 patients with acute migraine without aura to the real acupuncture or the sham acupuncture group at a 1:1 ratio. Both groups received 10 min of real acupuncture or nonpenetrating blunt needling. The primary outcome was the analgesic response rate of patients at 10 min.

This trial was conducted at the Second Affiliated Hospital, Yunnan University of Chinese Medicine from January 2023 to December 2024. All 80 patients provided complete data. At the primary end point of 10 min, the analgesic response rate was 92.5% (37 of 40) in the real acupuncture group compared to 12.5% (5 of 40) in the sham acupuncture group, with a between-group difference of 80.0% (95% confidence interval [CI], 64.4%-95.6%; p < 0.001). The real acupuncture group also demonstrated higher response rates from 2 to 8 min (differences ranging from 27.5% to 75.0%, all p < 0.05). At 1 min, the difference was 12.5% (95% CI, -0.2% to 25.2%; p = 0.995). Regarding pain intensity, the real acupuncture group exhibited a greater reduction in pain visual analog scale scores compared to the sham acupuncture group starting from 1 min (mean difference: -1.0; 95% CI, -1.3 to -0.6; p < 0.001) and peaking at 10 min (mean difference: -2.6; 95% CI, -3.0 to -2.2; p < 0.001). For accompanying symptoms, the real acupuncture group showed significantly lower scores for nausea/vomiting at 10 min (median [interquartile range (IQR)] 0.0 [0.0-1.0] vs. 1.0 [0.0-2.0]; p = 0.006), whereas no significant differences were observed for photophobia/phonophobia (median [IQR]: 0.0 [0.0-1.0] vs. 0.5 [0.0-2.0]; p = 0.098). No adverse events were observed during the trial.

The results of this study demonstrate that acupuncture can rapidly alleviate headache and accompanying symptoms in patients with acute migraine without aura attacks within 10 min, with the analgesic effect of the real acupuncture group being significantly superior to that of the sham acupuncture group. Future trials are needed to verify the reliability and generalizability of our findings.