Mapping the Knowledge Landscape of Acupuncture for Primary Headaches: A Bibliometric Analysis From 2005 to 2025

To provide an updated bibliometric overview of the research landscape, hotspots, and emerging trends of acupuncture for primary headaches (PH).

Publications related to acupuncture for PH were retrieved from the Web of Science Core Collection (WoSCC) for the period from January 1, 2005, to December 31, 2025. Only English-language articles and reviews were included. After manual screening based on title, abstract, publication year, document type, language, and topic relevance, 286 eligible publications were included. Bibliometric analyses and visualizations were performed using CiteSpace, VOSviewer, Bibliometrix, and Microsoft Excel.

The annual number of publications showed an overall upward trend, particularly after 2018. China was the leading contributor in terms of publication output and collaborative activity, followed by Germany, Italy, and the United States. Collaboration networks were identifiable at the country, institution, and author levels, although they remained concentrated among a limited number of leading countries and core research groups. The intellectual base of the field was mainly shaped by randomized controlled trials, systematic reviews, and evidence syntheses. Thematic analyses indicated that research was primarily centered on migraine, prophylaxis, efficacy, and headache-related clinical outcomes. Tension-type headache was also represented, whereas cluster headache and other less-studied PH subtypes received comparatively limited attention. Mechanism-related themes, including functional connectivity, neuroimaging, and trigeminocervical mechanisms, have emerged in recent years but remain less developed than the clinical literature.

Research on acupuncture for PH has become increasingly productive, structured, and clinically evidence-oriented over the past 2 decades. However, the field remains characterized by thematic concentration, selective collaboration, and relatively limited mechanistic depth. Future studies should place greater emphasis on underrepresented PH subtypes, broader interdisciplinary collaboration, and more rigorous translational and mechanistic investigation.