Acupuncture for migraine prevention: what UK guidance says

The NHS describes migraine as a condition that causes symptoms such as a severe headache, feeling sick and sensitivity to light. A migraine attack usually lasts between 4 hours and 3 days, and some people have attacks several times a week while others have them less often. Migraine cannot be cured, but the NHS says treatment can help manage the symptoms of an attack and prevent attacks.

Preventive treatment is usually discussed when attacks are frequent, severe or hard to control. The NHS suggests seeing a GP if your attacks are severe or getting worse, last longer than usual, happen more than once a week, or are difficult to control. NICE says clinicians should discuss the benefits and risks of prophylactic treatment with the person, taking into account their preference, other health conditions, risk of adverse events and the impact of headaches on quality of life.

On its migraine page the NHS lists the treatments to prevent migraine attacks as medicines such as beta blockers, antidepressants and medicines for epilepsy, acupuncture, relaxation techniques and cognitive behavioural therapy, and vitamin B2. It adds that you may have to try a combination of treatments before you find something that works, and that a GP may also suggest lifestyle changes such as eating at regular times and drinking less caffeine.

The NHS complementary therapies page explains that acupuncture involves needles being put in parts of the body to relieve pain, and that herbal medicines and complementary therapies are not tested in the same way as standard medicines. It says the NHS may offer acupuncture for people with long-term pain, migraine-type headaches or severe hiccups, depending on evidence and value for money. In practice, what is commissioned varies locally, so ask your GP what is available in your area.

NICE's headaches guideline (CG150, last updated June 2025 on the page read for this guide) recommends that clinicians consider propranolol, topiramate or amitriptyline for migraine prevention. It also gives specific cautions: topiramate should not be used for migraine prevention in pregnancy, or in women able to have children, unless the conditions of the Pregnancy Prevention Programme are fulfilled, and caution is needed when prescribing propranolol in people with depression because of the risk in overdose.

The acupuncture recommendation in the current text of the guideline is under prophylactic treatment for chronic tension-type headache: consider a course of up to 10 sessions over 5 to 8 weeks. The migraine prevention recommendations on the same page name the three medicines above rather than acupuncture. This is a useful reminder that views on acupuncture differ between sources, and that the NHS public page and the NICE guideline are not written to the same purpose. A GP or headache specialist can explain how this applies to you.

The NHS says acupuncture may not be safe for you if you are taking blood thinning medicine or are at increased risk of bleeding, or if you have a skin condition or skin infection. Tell any practitioner about your medical conditions, the medicines you take and any other treatments you are having.

The NHS also advises: do ask a GP about symptoms that do not go away or keep coming back rather than just talking to a therapist; tell any doctor or healthcare professional treating you if you use a complementary therapy; and do not stop prescribed medicines without talking to your doctor first. If you already take preventive medicines, acupuncture is generally discussed as something that sits alongside them rather than replaces them.

Preventing migraine does not remove the need to recognise symptoms that are not typical. The NHS says to call 999 if you or your child have a headache that came on suddenly and is extremely painful, problems speaking or remembering things, loss of vision or blurred or double vision, drowsiness or confusion, a seizure, a very high temperature with symptoms of meningitis, weakness in the arms or legs or on one side of the body or face, or a recent head injury.

It advises asking for an urgent GP appointment or getting help from NHS 111 if an attack has lasted longer than 72 hours, aura symptoms last longer than 1 hour at a time, or you are pregnant or have just had a baby.

NICE suggests a headache diary can be used to record the frequency, duration and severity of headaches, associated symptoms, medicines taken and possible triggers, and that it can help monitor how well an intervention is working. Recording attacks for a few weeks before and during a course of acupuncture gives you and your clinician something concrete to look at.

Be wary of overusing painkillers while you try preventive options. The NHS says to try not to take painkillers for more than 2 days a week as this can cause more headaches, and NICE asks clinicians to be alert to medication overuse headache and to explain the risk to people using acute treatments.

• Ask your GP whether NHS-commissioned acupuncture or a specialist headache service is available locally.

• If you go privately, check the practitioner is registered with a professional organisation accredited by the Professional Standards Authority.

• Keep a headache diary so you can judge whether it is helping.

• Keep taking prescribed preventive medicines unless a doctor advises otherwise.

On the NHS, preventive treatment usually starts with a GP, who may suggest medicines and lifestyle changes and refer you to a specialist if these do not help. Acupuncture is available on the NHS only in some areas and for some conditions, as the NHS complementary therapies page explains.

Many people choose private acupuncture. The NHS notes that other complementary therapists and herbal practitioners do not need to be registered by law, so checking registration and asking about training is worth doing. Whichever route you take, tell your GP so that your record is complete and any interactions or safety issues can be considered.