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Published on: June 2, 2014
Acupuncture versus Sham Acupuncture for Migraine without Aura: A Systematic Review and Meta-Analysis
Guoan Qi1, Mengting Li1, Shengen Zheng2
1Traditional Chinese Medicine Clinic, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, People's Republic of China.
Background:
Migraine without aura is a disabling disorder for which acupuncture is commonly used as a preventive therapy. Sham-controlled randomized trials provide a more rigorous estimate of acupuncture-specific effects than comparisons with usual care. We evaluated the efficacy of acupuncture versus sham acupuncture in adults with migraine without aura.
Methods:
We conducted a systematic review and meta-analysis of randomized sham-controlled trials. PubMed, Embase, Web of Science, CENTRAL, Scopus, and Wanfang were searched through 9 February 2026. The primary outcome was monthly migraine days (MMD). Secondary outcomes included migraine-specific quality of life (MSQ), pain intensity, and headache impact (HIT-6). Continuous outcomes were pooled as standardized mean differences (Hedges' g) using random-effects REML models with Hartung-Knapp adjustment. Certainty of evidence was assessed using GRADE.
Results:
Eight randomized trials involving 659 participants met the inclusion criteria. Compared with sham acupuncture, acupuncture reduced MMD (g = 0.46, 95% CI 0.27-0.64; I2 = 0%) and pain intensity (g = 0.49, 95% CI 0.25-0.72; I2 = 33%). MSQ showed a non-significant trend favoring acupuncture (g = 0.30, 95% CI -0.01 to 0.62; I2 = 59%). HIT-6 scores also favored acupuncture (g = 0.58, 95% CI 0.02-1.13), although heterogeneity was substantial (I2 = 80%). Sensitivity analyses did not materially alter the direction of effect. According to GRADE, certainty of evidence was low for MMD and pain intensity and very low for MSQ and HIT-6.
Conclusion:
Acupuncture was associated with reductions in migraine frequency and pain intensity compared with sham procedures in adults with migraine without aura. However, evidence certainty ranged from low to very low, and findings for quality of life and headache impact remain uncertain. Larger multicenter trials with standardized sham procedures and longer follow-up are needed.
Trial Registration:
The review protocol was registered in PROSPERO (CRD420261308589).
