Utility of Acupuncture Therapy for Adult Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis

Clinical Snapshot

Key Findings

• P Value: P<0.00001 for headache days reduction

• Effect Size: Headache days reduced by MD -0.72 post-intervention, SMD -0.70 at follow-up

• Primary Outcome: Headache frequency, days, intensity, duration, and analgesic use

• Nnt Or Sensitivity: Clinical significance unclear without confidence intervals and baseline values

• Confidence Interval: Not reported in abstract

Clinical Application

Requires access to qualified acupuncturists; treatment duration 4-12 weeks with sustained benefits Acupuncture covered by some private health insurers; not PBS-listed but available through qualified practitioners; aligns with RACGP recommendations for non-pharmacological headache management approaches Adults with chronic daily headache including chronic migraine and chronic tension-type headache seeking non-pharmacological prophylaxis

Abstract

BACKGROUND Chronic daily headache (CDH) management remains challenging due to limited efficacy of standard preventive pharmacotherapies. Acupuncture has shown promise in chronic headache management. This study evaluated its sustained prophylactic efficacy for CDH. MATERIAL AND METHODS Following PRISMA guidelines, we systematically searched PubMed, EMBASE, the Cochrane Library, CNKI, VIP, Sinomed, and Wanfang Data (inception to September 2025) for randomized controlled trials (RCTs) comparing acupuncture with other interventions for CDH. Primary outcomes included headache frequency, days, intensity, duration, and analgesic use; subgroup analyses covered treatment modality, CDH subtype, and duration. RESULTS Twenty-two RCTs (1449 patients) were included. Compared with control, acupuncture significantly reduced headache frequency (mean difference [MD], -0.32; P=0.001), headache days (MD, -0.72; P<0.00001), intensity (standardized mean difference [SMD], -0.63; P=0.001), duration (SMD, -1.18; P=0.0001), and analgesic use (MD, -0.52; P<0.00001) after the intervention. These benefits persisted during follow-up: headache days (standardized mean difference [SMD], -0.70; P<0.00001), intensity (SMD, -1.11; P=0.008), duration (SMD, -1.83; P=0.003), and analgesic use (SMD, -0.60; P=0.007) remained reduced; headache frequency showed a trend toward reduction (SMD, -0.47; P=0.05). Subgroup analyses revealed consistent efficacy across various CDH subtypes, including chronic migraine and chronic tension-type headache, treatment durations (4-12 weeks), and intervention strategies (acupuncture alone or combined with medication), indicating broad clinical applicability. CONCLUSIONS Acupuncture yields clinically meaningful, sustained improvements in CDH, supporting its role as an effective routine and adjunctive prophylaxis and broader application in this population.

References

1. 1.Nie, Y., Jing, R., Song, Z., & Zheng, H. (2026). Utility of Acupuncture Therapy for Adult Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis. Medical Science Monitor, 32, e952359. https://doi.org/10.12659/MSM.952359