Acupuncture for Treating Acute Attacks of Migraine: A Randomized Controlled Trial

Acupuncture has been used for centuries in traditional Chinese medicine to treat various types of pain, including migraine. However, until recently, scientific evidence on its efficacy in the specific treatment of acute migraine attacks was limited and inconsistent. Some previous studies had suggested that true acupuncture was not more effective than sham procedures, raising questions about whether the observed benefits were real or merely the result of the placebo effect. Migraine is a debilitating condition that affects millions of people worldwide, causing intense pain that is often pulsatile and unilateral, accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound.

Beyond personal suffering, migraine generates significant costs for the health system and negatively impacts patients' quality of life.

This study was conducted as a multicenter randomized controlled trial in China, involving seven hospitals. The primary objective was to investigate whether true acupuncture would be more effective than sham acupuncture in relieving pain during acute migraine attacks. The researchers recruited 218 patients with confirmed migraine diagnosis, of whom 175 were effectively included and randomized into three groups. The first group received true acupuncture at specific points traditionally used for migraine, while the other two groups received sham acupuncture at points not considered therapeutic in traditional Chinese medicine.

Each patient received only one treatment session and was followed for 24 hours. The main assessment method was the Visual Analog Pain Scale, a widely used tool that allows the patient to quantify their pain on a scale from 0 to 10 centimeters. Measurements were performed before treatment and at intervals of 30 minutes, 1 hour, 2 hours, and 4 hours after the procedure.

The results demonstrated that true acupuncture was significantly more effective than sham acupuncture in reducing pain. In the first two hours after treatment, only patients who received true acupuncture showed significant pain reduction, with a median decrease of 0.7 centimeters on the pain scale. At the fourth hour after treatment, although all groups showed some improvement, the true acupuncture group showed much greater reduction, with a median decrease of 1.0 centimeter on the pain scale, compared to only 0.5 centimeter in the first sham acupuncture group and 0.1 centimeter in the second sham group. In addition to pain reduction, the researchers observed that patients treated with true acupuncture had superior outcomes in other important aspects: 40.7% experienced complete pain relief, and 79.6% had no recurrence or intensification of pain in the 24 hours following treatment.

For patients suffering from frequent migraine, these results offer solid scientific evidence that acupuncture may be an effective therapeutic option for the treatment of acute attacks. Acupuncture proved capable not only of reducing pain intensity but also of preventing symptom recurrence in the short term. For health professionals, the study provides important data that can assist in clinical decision-making, especially for patients seeking alternatives to conventional medications or who do not adequately respond to pharmacologic treatments. The results also suggest that there is a real physiological difference between traditional acupuncture points and nonspecific points, contradicting theories that attribute the effects of acupuncture exclusively to placebo effect.

It is important to consider some study limitations when interpreting its results. The study assessed only one treatment session, not reflecting the usual clinical practice in which multiple sessions are generally performed. In addition, follow-up was limited to 24 hours, not allowing assessment of long-term effects. The study was also not completely blinded, as patients could potentially identify whether they were receiving true or sham acupuncture during treatment.

Adverse events were rare and mild, including isolated episodes of fainting, minor bleeding, and local pain, all with rapid recovery. Despite these limitations, this study represents a significant contribution to the scientific literature on acupuncture, providing robust evidence of its efficacy in treating acute migraine attacks and paving the way for future research on longer-duration treatments and their long-term effects.