Acupuncture and Migraines Plus 8 Acupressure Points to Get You Through The Pain
Migraine attacks can come on fast and furiously. For many they can be unrelenting and debilitating for days at a time. While there are various medications that can be used to treat the pain and to try to reduce migraine frequency, they can often cause unpleasant side effects. For this reason, some people are turning to alternative treatments, like acupuncture.
Clinical trial research (and our own experience) shows that acupuncture may have a positive effect on reducing migraine intensity and frequency. Here we wanted to provide some information around this topic and give some acupressure points you might like to try massaging at home when the next migraine hits.
What is the difference between a migraine and a headache?
Most of us have experienced a headache at some point in our lives, whether it be mild or severe they really aren’t fun. A migraine however is more than a severe headache. They are often associated with other symptoms, such as nausea and vomiting, an increased sensitivity to light, sound or certain smells, dizziness or extreme fatigue.
Around 20% of the Australian population experience migraines (1). For some, a migraine episode will come in 4 different stages. These include:
The Prodromal or Pre-headache Phase – these are usually painless symptoms that occur hours or days before the migraine itself. They may include mood swings, fatigue, intense yawning, appetite changes, muscle stiffness (especially in the neck and shoulders), constipation or diarrhoea. It’s worth keeping an eye out for these and noting down if they happen before a migraine arrives.
The Aura Phase – this occurs in around 20% of people with migraine and usually lasts around 5-60 minutes. It affects the persons senses; their vision, touch, hearing or speech, to cause things like blurred vision, flashing lights or zigzag patterns, numbness, ringing in the ears (tinnitus), or difficulty with talking.
The Headache Phase – this is when the pain attacks. It can be mild or debilitating and made worse with exposure to light, sound or smells. Interestingly, not everyone who experiences migraines will get this pain.
The Postdromal Phase – when the pain has subsided people may feel exhausted and need additional sleep, while some may feel more energetic. For others the nausea or sensitivity may continue for a couple of days.
Migraines will often (although not always), have a trigger associated with them. These can vary widely from person to person but some common triggers include environmental changes, such as sudden changes in the weather, certain foods (sadly coffee and red wine are a trigger for many), certain smells (strong perfumes can set people off), stress and lack of sleep. There can also be a strong hormonal link to migraines with women more likely to experience a migraine at certain times of the month. Unfortunately, it’s not always easy to avoid these triggers and they may occur more often than any migraine sufferer would like.
Does acupuncture work for migraines?
There have been many clinical trials in the last 10 to 15 years examining how acupuncture affects migraines. While the results have been somewhat mixed, the general consensus is that acupuncture is significantly better than no treatment and is at least as effective as, if not better than, prophylactic medications (2)
Firstly, does acupuncture reduce the severity of migraines?
A few systematic reviews published recently would answer yes to this question. (For those of you who aren’t into research, systematic reviews look at multiple clinical trials together for the quality of their research and the results found). One such review, published in 2020 by Giovanardi et al (3), examined 9 clinical trials which compared acupuncture to medication. They concluded that acupuncture has a moderately greater effect than medication in reducing pain intensity. They also found that fewer people in the acupuncture groups dropped out of the clinical trials due to adverse events (3).
Another systematic review published in 2018 examined pain relief and the quality of life in patients who suffer from frequent migraines (4). Compared to the previous review, this review also included clinical trials that used sham acupuncture as a control (this is acupuncture done in the wrong way or at the wrong point). From the 12 clinical trials included in their review, they found that acupuncture provided better pain relief and quality of life than either sham acupuncture or medication (4).
But does acupuncture also affect how frequently migraines occur?
A recent systematic review of 22 clinical trials including a total of 4,985 participants concluded that acupuncture can reduce the frequency of migraine headaches (5). Overall, they found a 50% reduction in migraine frequency in 41% of patients who tried acupuncture, compared to only 17% in the non-treatment groups. More importantly, they, and other clinical trials and reviews published since then, suggest that acupuncture is significantly better than sham acupuncture at reducing migraine frequency and is just as effective as prophylactic medications, but without the nasty side effects. (5, 6, 7, 8).
Does the effect of acupuncture last for a while? And how many treatments might be needed?
While not many people have started to look in detail at these questions, it is generally thought that acupuncture can potentially have quite a long-lasting effect. In 2017, Zhao et al ran a clinical trial (9) with 245 people where they divided them into groups of either true acupuncture, sham acupuncture or no treatment, and treated them 5 days a week for 4 weeks. They then checked back to see how those people were feeling 8, 12 and 20 weeks after the treatments. Amazingly they found that even at the 20-week stage those who had received the true acupuncture had a significant reduction in migraine frequency and severity compared to the control groups (9).
From the study above you might think that this is a large number of treatments to have (to be honest 20 treatments in one month isn’t always practical or possible). Most of the studies examining acupuncture and migraine provide between 6 and 16 treatments over a 1 to 3 month period. While we do believe that one acupuncture treatment may have some small effect, we recommend trying a course of 4 to 6 treatments. We would then reassess your condition to determine the effect it is having.
What’s the conclusion overall?
So, it appears that acupuncture can potentially be quite effective in treating migraine, but many of these systematic reviews and analyses suggest that the quality of the evidence is still low. More clinical trials will no doubt be done in the future looking at all aspects of acupuncture with migraine.
Regardless, if you’re someone who suffers frequent and debilitating migraines it might be worth giving acupuncture a go. And in the meantime, here are a few acupuncture points we suggest massaging next time you feel a migraine coming on.
Acupressure – 8 great points for migraine
It’s not always easy, or practical, to get an acupuncture treatment when you feel a migraine coming on. But remember, before there was acupuncture (and the super fine needles we currently use), there was acupressure. Acupressure is effectively a gentle (or strong) massage at specific points on the body. You can do it yourself, or you could ask a friend or relative to massage the point for you.
How to perform acupressure
First, find a quiet place where you can relax, either sitting or lying down.
Locate the pressure point you are targeting (take a look at the descriptions and pictures below).
Use your knuckle, thumb, or soft-pointed object like a pencil eraser to apply pressure to each point.
Apply pressure for 15 to 30 seconds. Relax and repeat 5-10 times.
When applying acupressure, try to relax and breathe deeply as you massage the area.
Repeat using the same point on the other side of your body.
LI4 (He Gu, Joining Valley)
This point is located on the back of the hand, in the fleshy webbing between the thumb and the forefinger. It will often feel more tender when you have a migraine or headache. This point is good for lots of things related to the head and face, such as pain around or behind the eyes, toothache or neck pain and it’s also used for hypertension. However, do not use this point if you are pregnant as it is also used to prepare for labour and bring on contractions.
GB20 (Feng Chi, Wind Pool)
This point is located on the back of the neck, at the base of the skull on either side of the spine. Find the tender point and apply gentle pressure. If you spend your day sitting at a desk it can be worthwhile massaging this point a few times each day, even if you don’t have a migraine.
DU20 (Bai Hu, One Hundred Meetings)
Locate this point on the top of the head, slightly back from the centre and in line with the ears. It’s a lovely calming point but can also give you an energy boost.
Yin Tang (Hall of Impression, Third Eye)
This point is right between the eyebrows. It’s great for sinus type headaches and eyestrain and is also a lovely calming point. You can even use it to calm you dog if they get frightened in a storm.
SJ5 (Wai Guan, Outer Pass)
Located on the back of the forearm, approximately 2 or 3 finger widths from the wrist. It’s especially good if your migraine headache is brought on by being out in the wind or changes in the weather.
PC6 (Nei Guan, Inner Pass)
This point is on the opposite side of the wrist to SJ5 making it easy to use them together. It’s on the inside of the forearm, approximately 2 or 3 finger widths from the wrist. This is the classic point for nausea and vomiting.
LIV3 (Tai Chong, Great Rushing)
You’ll find this point on the foot between the big toe and second toe. Slide you finger up a few centimetres from the webbing between your toes to the tender point. This point can actually be used for all types of pain. It’s a great one to get your Qi moving.
GB41 (Zu Lin Qi)
This is another point found on the foot, this time a few centimetres up from your little toe. You’ll feel it on the outside of the tendon. As well as headaches, this point may also be good for sciatica and hip pain.
References:
1. https://headacheaustralia.org.au/migraine/
2. McDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (Revised Edition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. http://www.acupuncture.org.au/
3. Giovanardi CM, Cinquini M, Aguggia M, Allais G, Campesato M, Cevoli S, Gentili F, Matrà M and Minozzi S (2020) Acupuncture versus phrarmacological prophylaxis of migraine: a systematic review of randomised controlled trials. Frontiers in Neurology 11: :576272. doi: 10.3389/fneur.2020.576272
4. Jiang Y, Bai P, Chen H, Zhang X, Tang X, Chen X, Hu X, Wang X, Li X, Li Y and Tian G-H (2018) The effect of acupuncture on quality of life in patients with migraine: a systematic review and meta-analysis. Frontiers in Pharmacology; 9. Article No. 1190. doi: 10.3389/fphar.2018.01190
5. Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, Vickers A, White AR (2016) Acupuncture for prevention of episodic migraine (Review). Cochrane database of systematic reviews. Issue 6. Art. No.: CD001218. doi: 10.1002/14651858.CD001218.pub3.
6. Tort S, Ciapponi A (2019) How does acupuncture compare with drug treatment for preventing episodic migraine? Cochrane Clinical Answers https://doi.org/10.1002/cca.2578
7. Xu S, Yu L, Luo X, Wang M, Chen G, Zhang Q, Liu W, Zhou Z, Song J, Jing H, Huang G, Liang F, Wang H and Wang W (2020) Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: a multicentre, randomised clinical trial. British Medical Journal, 368: doi: 10.1136/bmj.m697
8. Ou M-Q, Fan W-H, Sun F-R, Jie W-X, Lin M-J, Cai Y-J, Liang S-Y, Yu Y-S, Li M-H, Cui L-L and Zhou H-H (2020) A systematic review and meta-analysis of the therapeutic effect of acupuncture on migraine. Frontiers in Neurology, 11:596. doi: 10.3389/fneur.2020.00596
9. Zhao L, Chen J, Li Y, Xin S, Xiaorong C, Zheng H, Gong B, Huang Y, Yang M, Wu X, Li X and Liang F (2017) The long-term effect of acupuncture for migraine prophylaxis. JAMA. 177(4): 508-515