Acupuncture relieves tension-type headache

Bottom line

The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with frequent tension-type headache.

Tension-type headache is a common type of headache. Mild episodes may be treated adequately by pain-killers. In some individuals, however, tension-type headache occurs frequently and significantly impairs their quality of life. Acupuncture is a therapy in which thin needles are inserted into the skin at particular points. It originated in China and is now used in many countries to treat tension-type headache. We found randomised controlled trials to evaluate whether acupuncture prevents tension-type headache. We looked mainly at the numbers of people who responded to treatment, which means a halving of the number of days on which they experienced a headache

Key results

We reviewed 12 trials with 2349 adults, published up to January 2016. One new trialis included in this updated review.

Acupuncture added to usual care or treatment of headaches only on onset (usually with pain-killers) in two large trials resulted in 48 in 100 participants having headache frequency at least halved, compared to 17 of 100 participants given usual care only.

Acupuncture was compared with ‘fake’ acupuncture, where needles are inserted at incorrect points or do not penetrate the skin, in six trials. Headache frequency halved in 52 of 100 participants receiving true acupuncture compared with 43 of 100 participants receiving ‘fake’ acupuncture. The results were dominated by one large, good quality trial (with about 400 participants), which showed that the effect of true acupuncture was still present after six months. There were no differences in the number of side effects of real and ‘fake’ acupuncture, or the numbers dropping out because of side effects.

Acupuncture was compared with other treatments such as physiotherapy, massage or relaxation in four trials, but these had no useful information.

Quality of the evidence

Overall the quality of the evidence was moderate.


Acupuncture has been used to treat headaches for millennia. However we live in a world where empirical evidence from traditional medicines is  rejected by the mainstream so it is always pleasing to see Cochrane group publish a conclusion that Acupuncture works.


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