Acupuncture for Migraine and Tension Headaches: What NICE Recommends and What a Course Looks Like

If you live with migraine, you probably know the routine better than anyone. The flicker at the edge of your vision, or the stiff neck that arrives the day before. The tablets you take at the first sign. The dark room, the cancelled plans, the day after when your head feels like it's been through a wash cycle. And if your headaches are the tension type, you'll know the band that tightens across your forehead by mid-afternoon and seems to have taken up permanent residence.

Headaches are one of the most common reasons people book with me, and they're also one of the areas where I can talk about evidence with more confidence than most. This guide explains what NICE says, what a course of acupuncture looks like, and how to work out whether it's helping.

Migraine and tension-type headache

The two are different conditions. Tension-type headache is the most common kind of headache: usually a pressing or tightening pain on both sides of the head, mild to moderate, and not made worse by walking about. It becomes "chronic" when it happens on 15 or more days a month for more than three months.

Migraine is usually a moderate to severe throbbing pain, often on one side, and commonly comes with nausea, sensitivity to light or sound, and sometimes aura, such as visual disturbance. Migraine is around three times as common in women as in men, and many women notice attacks clustering around their period or changing during perimenopause. If that sounds familiar, my guides to irregular cycles and menopause are worth reading alongside this one.

What NICE recommends

NICE's headache guideline, CG150, sets out how GPs should diagnose and manage headaches in people over 12. On prevention, it says:

• For chronic tension-type headache, a course of up to 10 sessions of acupuncture over 5 to 8 weeks can be considered.
• For migraine, the same course can be considered when the usual preventive medicines (topiramate and propranolol, with amitriptyline also commonly used) are unsuitable or haven't worked, depending on your preference, other health conditions and the risk of side effects.

That second point matters more for women than it might first appear. In 2024, the medicines regulator, the MHRA, introduced a pregnancy prevention programme for topiramate because of risks in pregnancy. For women who might become pregnant, topiramate may not be a suitable option, and that's one of the situations in which a GP may discuss alternatives, including acupuncture.

The Advertising Standards Authority, which oversees health claims in UK advertising, has accepted clinical evidence that acupuncture can give short-term relief of tension-type headaches and of migraine headache. The word "short-term" is important, and I use it deliberately. The relief isn't permanent, and how long it lasts varies from person to person.

Start a headache diary before your first appointment

NICE recommends a headache diary, ideally kept for at least eight weeks, to help with diagnosis and to monitor treatment. It's also the only fair way to judge whether acupuncture is earning its place. Note:

• the date and time each headache starts, and how long it lasts
• how severe it is, out of ten
• any symptoms alongside it, such as nausea, light sensitivity or aura
• what medication you took, and when
• possible triggers, including your menstrual cycle, sleep, meals, alcohol and stress

Bring a few weeks of this to your first appointment if you can. If you take painkillers or triptans on many days each month, mention it to your GP as well, because frequent use can itself cause headaches, a pattern called medication overuse headache.

What a course of acupuncture with me looks like

Your first appointment lasts 60 to 75 minutes. I'll go through your headache history, your diary, your medication and the rest of your health, including sleep, neck and shoulder tension, digestion and, for women, your cycle. Then you'll rest for twenty to thirty minutes with a small number of fine needles in place. Points are often on the hands, feet, neck and head. My guide to your first acupuncture appointment explains what the needles feel like.

Following the NICE structure, I usually suggest weekly sessions to begin with. After five or six, we sit down with your diary and compare it with where you started. If the numbers have moved in a meaningful way, we can plan the rest of the course and talk about what happens after it. If they haven't, I'll say so, and you won't be encouraged to keep paying for something that isn't helping.

You can carry on with your usual migraine medication throughout. Acupuncture sits alongside it, and any change to prescribed medication should be discussed with your GP.

How Chinese medicine looks at headaches

Alongside the evidence, I also use traditional Chinese medicine to plan treatment. In that framework, where a headache sits matters, whether at the temples, the forehead, behind the eyes or at the back of the neck, as do its quality and timing. A headache that comes with tiredness after a busy week is read differently from one that arrives with heat and irritability before a period. It's a traditional way of organising information, and I use it to choose points, not as a medical diagnosis.

On the NHS or private?

Some GP surgeries and NHS physiotherapy services offer acupuncture, but provision varies, and in practice most people in the UK who have acupuncture for headaches pay privately. If you go privately, check that your practitioner is on an accredited register, such as the British Acupuncture Council's.

Cost

As of April 2026, an initial acupuncture appointment is £76 and follow-ups are £56. A course in line with the NICE structure, an initial appointment plus up to nine follow-ups, would cost up to £580 in total, and many people review after five or six sessions. Full details are on my prices page. The clinic is in Upper Rissington, with off-road parking, and people come from Cheltenham, Bourton-on-the-Water, Stow-on-the-Wold and Burford.

Frequently asked questions

Does NICE recommend acupuncture for migraine?

NICE guideline CG150 says a course of up to 10 sessions of acupuncture over 5 to 8 weeks can be considered to help prevent migraine when the usual preventive medicines are unsuitable or have not worked, and to help prevent chronic tension-type headache.

How many acupuncture sessions are needed for migraine?

NICE describes a course of up to 10 sessions over 5 to 8 weeks. At Resolve, treatment usually starts weekly, and progress is reviewed against a headache diary after five or six sessions to decide whether to continue.

How long does relief from acupuncture last?

UK advertising regulators accept evidence that acupuncture can give short-term relief of migraine and tension-type headache. Relief is not permanent, and how long it lasts varies from person to person, which is why progress is tracked and reviewed.

Can I keep taking my migraine medication during acupuncture?

Yes. Acupuncture can be used alongside migraine medication. Keep taking prescribed medicines as directed and speak to your GP before changing them. If you take painkillers or triptans on many days each month, ask your GP about medication overuse headache.

When is a headache an emergency?

Call 999 or go to A&E for a sudden, severe headache that peaks within minutes, a headache after a head injury, or a headache with weakness, confusion, slurred speech, a seizure, a high temperature with a stiff neck or rash, or changes to your vision.