Acupuncture

What it is used for

Acupuncture is the technique of piercing the body with a solid needle for therapeutic purposes. Acupuncture is extremely safe if delivered by trained practitioners.

There is some evidence to show that acupuncture can help prevent migraine, although not a considerable amount.

Types of acupuncture

There are two main types of acupuncture, the traditional Chinese and the Western medical acupuncture.

1. Traditional Chinese medical concepts describe illness and disease as a disturbance of qi (a form of energy or ‘vital force’) within the body. Qi is said to flow along fourteen meridians on the body surface on which the acupuncture points are situated. Acupuncture aims to re-establish the correct flow of qi throughout the meridians. Diagnosis may include detailed examination of the pulse and tongue. Needle placement is individualised, so each patient with migraine might receive a different number and distribution of needles. This is often combined with dietary advice and Chinese herbal treatment.
2. Western medical acupuncture is a modern scientific approach which is based on the biological effects of needling and on clinical and laboratory research. Acupuncture has been found to have effects on the nervous system, including locally where the needles are placed, in the spinal cord and brainstem, where a ‘damping effect’ occurs on pain transmission, and in areas of the brain which regulate the emotional aspects of pain. Western medical acupuncture uses both local points (for instance on the head and neck) and distant points (such as hands and feet).

How it is used

The National Institute for Health and Care Excellence (NICE) includes acupuncture as a treatment to be considered to prevent chronic tension-type headache and migraine. However, there is no requirement for health professionals to prescribe acupuncture.

• For chronic tension‑type headache, it says that a course of up to 10 sessions of acupuncture over 5–8 weeks can be considered.
• For migraine, it says that a course of up to 10 sessions of acupuncture over 5–8 weeks can be considered if both migraine preventive treatments topiramate and propranolol are unsuitable or ineffective (these guidelines were published in 2015, before the availability of a range of newer migraine preventive treatments). It said that this would also depend on the patient’s choice of treatment, other conditions they may have, and risk of adverse effects to them from the treatment.

Getting acupuncture

While acupuncture it not widely available across the NHS, almost all NHS pain clinics use it as a treatment and increasing numbers of GPs and physiotherapists are using it too.

The majority of acupuncture treatment in the UK is provided in private practice by professional (lay) acupuncturists who are not from an orthodox medical background.