Acupuncture versus Sham Acupuncture for Migraine without Aura: A Systematic Review and Meta-Analysis
In brief
Acupuncture cuts migraine days and pain intensity by about half a SD
A meta-analysis of eight sham-controlled trials (659 adults) found that acupuncture reduced monthly migraine days and headache pain intensity by roughly 0.5 standard deviations compared with sham acupuncture. The benefit was consistent across studies, but the evidence was rated low to very low certainty, so larger, well-designed trials are needed to confirm its true clinical value.
- Journal
- Journal of pain research (Q1)
- Published
- 10 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Guoan Qi, Mengting Li, Shengen Zheng, Xu Xu
- PMID
- 42454004
- DOI
- 10.2147/JPR.S616522
Why clinicians should know about it
- Picked for Complementary and Alternative Medicine (top studies of the week, 19 July 2026): SR/MA of acupuncture vs sham for migraine
Abstract
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).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.