Acupuncture versus Sham Acupuncture for Migraine without Aura: A Systematic Review and Meta-Analysis
Abstract
Background: Migraine without aura is a disabling disorder for which acupuncture is commonly used as a preventive therapy. Sham-controlled randomized trials provide a more rigorous estimate of acupuncture-specific effects than comparisons with usual care. We evaluated the efficacy of acupuncture versus sham acupuncture in adults with migraine without aura.
Methods: We conducted a systematic review and meta-analysis of randomized sham-controlled trials. PubMed, Embase, Web of Science, CENTRAL, Scopus, and Wanfang were searched through 9 February 2026. The primary outcome was monthly migraine days (MMD). Secondary outcomes included migraine-specific quality of life (MSQ), pain intensity, and headache impact (HIT-6). Continuous outcomes were pooled as standardized mean differences (Hedges' g) using random-effects REML models with Hartung-Knapp adjustment. Certainty of evidence was assessed using GRADE.
Results: Eight randomized trials involving 659 participants met the inclusion criteria. Compared with sham acupuncture, acupuncture reduced MMD (g = 0.46, 95% CI 0.27-0.64; I2 = 0%) and pain intensity (g = 0.49, 95% CI 0.25-0.72; I2 = 33%). MSQ showed a non-significant trend favoring acupuncture (g = 0.30, 95% CI -0.01 to 0.62; I2 = 59%). HIT-6 scores also favored acupuncture (g = 0.58, 95% CI 0.02-1.13), although heterogeneity was substantial (I2 = 80%). Sensitivity analyses did not materially alter the direction of effect. According to GRADE, certainty of evidence was low for…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 659 participants or records.
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