Efficacy of Real Acupuncture Compared with Sham Acupuncture for Prophylaxis of Migraine without Aura A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Background and Objective: Migraine without aura is a common neurological condition for which acupuncture is frequently used as a prophylaxis; however, its efficacy beyond sham acupuncture remains uncertain. This systematic review and meta-analysis compared the effectiveness of real acupuncture versus sham acupuncture in adults with migraine without aura. Methods: We systematically searched major databases from inception till March 2026. We included randomized controlled trials (RCTs) that compared real acupuncture with sham acupuncture in adults diagnosed with migraine without aura, based on the International Classification of Headache Disorders criteria. Monthly migraine days (MMDs) and migraine frequency change from baseline were the primary outcomes. Pain intensity (VAS), migraine-specific quality of life (MSQ), headache-related disability (HIT-6), and acute medication use were secondary outcomes. We pooled data using a random-effects model and assessed risk of bias with the Cochrane RoB 2 tool. Results: We included eight RCTs with a total of 915 participants. There was nosignificant reduction in MMDs (MD = −0.44; 95% CI: −1.09 to 0.21; P = 0.18; I2 = 56%) or migraine frequency (MD = −0.09; 95% CI: −0.91 to 0.72; P = 0.82; I2 = 82%). HIT-6 (P = 0.92), VAS (P = 0.33), and acute medication use (P = 0.22) were also not significant. Real acupuncture, however, improved MSQ Emotional Function (P = 0.04) and MSQ Role Preventive (P = 0.003). Several outcomes showed marked heterogeneity. Sensitivity analyses materially affected pooled results. Conclusion: In individuals with migraine without aura, real acupuncture did not significantly outperform sham acupuncture for reducing migraine frequency or monthly migraine days. However, improvements in some quality-of-life areas suggest a possible benefit. These findings highlight the need for well-designed studies with standardized procedures to clarify the efficacy of acupuncture beyond sham effects.  

Keywords

References

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