Many reports have shown acupuncture to be useful in the treatment of migraines. In a preliminary trial, 18 of 26 people suffering from migraine headaches demonstrated an improvement in symptoms following therapy with acupuncture; they also had a 50% reduction in the use of pain medication.² Previous preliminary trials have demonstrated similar results,^{3, 4, 5} which have also been confirmed in placebo-controlled trials.^{6, 7} Improvement has been maintained at one⁸ and three⁹ years of follow-up. In preliminary research, patients suffering from chronic headaches of various types (including migraine, cluster, or tension headaches) have also experienced an improvement in symptoms following acupuncture treatment.¹⁰ In a trial comparing acupuncture to traditional drug therapy, a significantly greater cure rate was achieved in the acupuncture group relative to the drug treatment group (75% vs. 34%).¹¹

Dry needling is a form of acupuncture that does not utilise traditional Chinese medicine diagnosis or traditional acupuncture points for treatment. Instead, acupuncture needles are inserted into painful muscle areas (trigger points). A study of 85 patients comparing dry needle acupuncture to conventional drug therapy found a similar reduction in frequency and duration of migraine attacks in both treatment groups.¹²

Percutaneous Electrical Nerve Stimulation (PENS) is an electrical nerve stimulation technique that has become increasingly popular in the complementary and alternative management of pain syndromes. PENS involves insertion of needle probes, similar to acupuncture, at specific therapeutic points and then applying low levels of electrical current. In one study, PENS was significantly more effective than needles alone at relieving pain in migraine headaches (tension headaches and post-traumatic headaches were also improved).¹³

Practitioners of manipulation report success in treating migraine with manipulation.¹⁴ Migraine sufferers are reported to often have neck pain, tenderness of the spinal joints of the neck,¹⁵ and limited ability to move the neck,¹⁶ all of which suggest the presence of neck problems that could respond to manipulation. Two preliminary trials reported significant benefit to 75–80% of migraine patients treated with manipulation,^{17, 18} while a third preliminary trial reported reductions in headache frequency and duration, nausea, and sensitivity to light one year after the completion of a two-month course of manipulation.¹⁹ A controlled trial compared three types of manipulation and found all three provided significant improvement in headache frequency, severity, and duration.^{20, 21} Another controlled trial compared two months of manipulation to sham (fake) manipulation and to placebo treatment with a non-functioning electrical unit. People in the manipulation group had significantly more improvement of headache frequency and duration, and of ability to function in daily life; they also used less medication.²² The largest controlled trial to date compared eight weeks of manipulation, drug therapy, or both treatments in combination. Manipulation was as effective as the medication in reducing an overall score of migraine suffering, but had fewer reported side effects.²³