Migraines - Wokingham, Berkshire

1. Overview

Migraines are a type of severe, recurrent headache disorder characterised by attacks that typically last between 4 and 72 hours and produce moderate to severe, often disabling pain. They are the third most common disease and the second most disabling neurological condition in the world, carrying an enormous personal, social and economic burden. A UK follow-up study found the migraine incidence rate to be 3.69 cases per 1,000 person-years, occurring approximately 2.5 times more frequently in women than men, with hormonal factors — particularly the relationship with the menstrual cycle — playing an important role.

Conventional prophylactic medications including beta-blockers, amitriptyline and sodium valproate can reduce attack frequency, but all carry significant adverse effects and do not work for all patients. Acupuncture has an exceptionally strong evidence base for migraine prevention: multiple systematic reviews and meta-analyses now confirm that it is at least as effective as prophylactic drug treatment and produces superior quality of life outcomes, with minimal adverse effects. I have helped many patients suffering from migraines, both in reducing attack frequency and in managing acute episodes.

2. Symptoms

A migraine attack typically progresses through up to four phases, though not all phases are present in every attack or every patient:

Prodrome (hours to days before) — subtle warning signs including mood changes (depression, euphoria or irritability), food cravings, neck stiffness, increased yawning, increased thirst and urination, and sleep disturbance
Aura (20–60 minutes before or during) — reversible neurological symptoms present in approximately one third of migraine sufferers; most commonly visual disturbances (zigzag lines, flashing lights, blind spots), but can also include sensory changes (tingling or numbness in the face, arm or hand), speech difficulties, limb weakness (hemiplegic migraine) or vestibular symptoms
Headache phase — typically unilateral (one-sided) pulsating or throbbing pain, though bilateral pain occurs in many cases; moderate to severe intensity; worsened by routine physical activity; lasting 4–72 hours; accompanied by nausea, vomiting, and heightened sensitivity to light (photophobia) and sound (phonophobia), and in some cases smell (osmophobia)
Postdrome (hours to a day after) — the “migraine hangover”; lingering fatigue, cognitive fog, mood changes and scalp tenderness following resolution of the headache phase; often as disabling as the headache itself

Migraine subtypes include: migraine without aura (the most common); migraine with aura; chronic migraine (15 or more headache days per month, with at least eight being migrainous); menstrual migraine (closely linked to the hormonal fluctuations of the menstrual cycle); and vestibular migraine (featuring dizziness and balance disturbance as prominent symptoms). Tinnitus and neck muscle pain are also common associated features.

3. Causes and triggers

Migraines arise from a complex interplay of genetic predisposition and environmental triggers. The pathophysiology involves cortical spreading depression (a wave of neuronal and glial depolarisation that propagates across the cortex and is responsible for the aura), activation of the trigeminovascular system and release of inflammatory neuropeptides including calcitonin gene-related peptide (CGRP), which causes vascular dilation and neurogenic inflammation in the meningeal vessels, and central sensitisation of pain pathways. Individual triggers vary considerably between patients and often require careful diary-keeping to identify reliably. The most common triggers include:

Hormonal changes — oestrogen fluctuations during the menstrual cycle, particularly the perimenstrual drop in oestrogen, are the most potent trigger in women; migraine frequency often increases around perimenopause and reduces after menopause
Stress and emotional changes — both acute stress and the relaxation after a period of high stress (“let-down migraines”) are common triggers; anxiety and depression are comorbid in a significant proportion of migraine sufferers
Sleep disruption — both too little and too much sleep can trigger attacks; insomnia and irregular sleep patterns are strongly associated with increased migraine frequency
Dietary triggers — alcohol (particularly red wine and beer), caffeine (both excess and withdrawal), aged cheeses, processed meats, monosodium glutamate, dark chocolate and irregular meal timing or skipping meals (hypoglycaemia) are common triggers
Sensory stimuli — bright or flickering lights, strong smells (perfumes, smoke), loud sounds and screen exposure can trigger attacks in susceptible individuals
Physical factors — neck tension and muscle pain, poor posture, physical exertion and dehydration
Weather and environmental changes — changes in barometric pressure, temperature extremes, bright sunlight and travel across time zones
Medications — certain medications can trigger or worsen migraines, including oral contraceptives in susceptible women and — paradoxically — medication overuse (taking acute migraine medications more than 10 days per month leads to medication overuse headache, which perpetuates and worsens the migraine cycle)

4. Migraines in Chinese medicine

In traditional Chinese medicine (TCM), migraines are classified within the category of “Tou Tong” (head pain) and more specifically “Pian Tou Tong” (one-sided head pain), which directly corresponds to the laterality that characterises most migraines. The condition is understood in TCM as arising from pathological Qi and Blood disturbance in the channels traversing the head — most commonly the Gallbladder and Liver channels, which run along the temporal and lateral aspects of the head that are the most frequent migraine pain locations. The most clinically important TCM patterns are:

Liver Yang rising (Gan Yang Shang Kang) — the most common migraine pattern in clinical practice; characterised by one-sided throbbing, pulsating pain, often worse on exertion, with accompanying dizziness, irritability, red eyes and a flushed face; triggered by stress, anger and alcohol. The underlying root is typically Liver and Kidney Yin deficiency that fails to anchor rising Liver Yang. This pattern is treated by calming Liver Yang, nourishing Liver and Kidney Yin and clearing the Gallbladder channel; key acupoints include GB20 (Fengchi), GB8 (Shuaigu), LR3 (Taichong) and KI3 (Taixi)
Liver Qi stagnation transforming into Fire — intense, severe unilateral pain that comes on suddenly and is closely related to emotional upset, frustration or anger; the pain has a burning or explosive quality; the tongue is red with a yellow coating. Liver Qi stagnation that has accumulated and transformed into Fire drives Qi and Blood upward into the head with force. Treatment clears Liver Fire, moves Qi and Blood in the Gallbladder channel and cools the head
Phlegm-Damp obstructing the clear orifices — a heavier, duller or more constant unilateral headache, often accompanied by nausea and vomiting (the migraine’s characteristic associated symptoms correspond exactly to Phlegm-Damp rising and obstructing the Stomach), dizziness, a feeling of heaviness in the head, a thick greasy tongue coating and poor digestion. This pattern is common in patients with dietary triggers and is treated by resolving Phlegm, transforming Damp, harmonising the Stomach and unblocking the channels
Blood stasis obstructing the head channels — a fixed, stabbing or boring unilateral pain that is worse at night and may be associated with a longer history of recurring migraines (longstanding pain in TCM tends to involve Blood stasis); a purple tinge to the tongue or purple spots; a history of head injury can also produce this pattern. Treatment invigorates Blood, removes stasis and opens the Collaterals in the head; key herbs include Chuan Xiong (Ligusticum) and acupoints include BL17 (Geshu) and local points on the Gallbladder channel
Qi and Blood deficiency — a dull, aching, less severe migraine that is worse after exertion or mental effort, better after rest and sleep; often aggravated by fatigue, after periods of hard work, or around menstruation in women with Blood deficiency. Sleep is a key remedy for this pattern — most migraines of this type resolve with rest, because sleep rejuvenates Qi and Blood levels. Treatment tonifies Qi and Blood, nourishes the Liver and supports the brain
Kidney essence deficiency — a more chronic, deep-seated headache pattern with an empty, hollow quality; often associated with tinnitus, low back weakness, fatigue and poor memory; more common in older patients or those with constitutional deficiency. Treatment nourishes Kidney Jing and Yin and tonifies the brain

5. Acupuncture for migraines

Acupuncture is one of the most evidence-based non-pharmacological treatments for migraines, with consistent findings across dozens of high-quality randomised controlled trials and multiple systematic reviews confirming its effectiveness for both prevention (prophylaxis) and acute treatment. Acupuncture is now recommended as a prophylactic treatment option for migraine by NICE in the UK. Its mechanisms of action include:

Modulating the trigeminovascular system by reducing CGRP release and inhibiting neurogenic inflammation in the meningeal vessels that drives the headache phase
Regulating serotonin (5-HT) pathways: acupuncture influences serotonin synthesis, release and receptor sensitivity, directly addressing one of the key neurotransmitter imbalances underlying migraine susceptibility
Reducing cortical excitability and the threshold for cortical spreading depression (the electrophysiological event responsible for migraine aura)
Releasing endogenous opioids (endorphins, enkephalins) and other neuropeptides that inhibit pain transmission and raise the pain threshold
Improving blood flow regulation in the cerebral and meningeal vasculature, addressing the vascular component of migraine pathophysiology
Reducing neck and shoulder tension, which is both a trigger and a perpetuating factor for migraine; acupuncture at GB20 (Fengchi), GB21 (Jianjing) and BL10 (Tianzhu) directly releases the occipital and cervical muscles implicated in migraine
Balancing hormonal fluctuations by influencing the hypothalamic-pituitary-ovarian axis, which is particularly relevant for menstrual migraine
Reducing co-morbid anxiety, depression and insomnia, all of which are both triggers and consequences of chronic migraine

Research evidence

A systematic review and meta-analysis published in Systematic Reviews (2025), searching seven databases through May 2024, included 23 RCTs comprising 2,295 patients and found that compared with sham acupuncture, acupuncture significantly reduced migraine duration (MD: −4.36 hours), the number of migraine attacks (MD: −0.82) and migraine days per four weeks (MD: −1.38), and improved quality of life scores compared with pharmacological treatment. A network meta-analysis published in the Journal of Pain Research (2024), analysing 34 studies involving 3,365 patients across nine databases, demonstrated that acupuncture reduced pain intensity (VAS) better than medication (MD: −1.29), with greater reductions in attack frequency (MD: −1.95), duration (MD: −3.29) and attack days (MD: −1.02). A dose-response meta-regression published in Complementary Therapies in Clinical Practice (2024), including 32 RCTs involving 1,562 participants across eight databases to June 2024, found a J-shaped dose-response relationship between acupuncture sessions and migraine attack frequency: 7 to 16 sessions produced optimal reductions, with 16 sessions reducing attack frequency by 3.95 episodes (95% CI: 3.13–4.77), and 3 sessions per week reducing frequency by 4.04 — consistent with the Cochrane finding that 16 or more sessions yield superior outcomes to shorter courses.

Acupuncture is at least as effective as prophylactic drug treatment, with far fewer contraindications and adverse side effects. It can be used both for prevention during attack-free periods and to alleviate symptoms during acute attacks. There is also qualitative evidence that acupuncture improves patients’ coping mechanisms and overall sense of control over their condition. I have helped many people — both men and women — who are migraine sufferers or have a high frequency of headaches. Regular weekly sessions are advised with a minimum of six sessions as an initial course of treatment.

6. Chinese herbal medicine for migraines

Chinese herbal medicine provides daily preventive support between acupuncture sessions, addressing the underlying constitutional patterns that make migraine sufferers vulnerable to attacks. For patients with frequent migraines or strongly rooted constitutional patterns, the combination of acupuncture and Chinese herbs produces better outcomes than either treatment alone. Key formulae used in clinical practice include:

Tian Ma Gou Teng Yin (Gastrodia and Uncaria Drink) — the primary formula for Liver Yang rising with Liver-Kidney Yin deficiency; directly targets one-sided throbbing migraines with dizziness, irritability and stress-related triggers; contains Tian Ma (Gastrodia), Gou Teng (Uncaria) and Shi Jue Ming (Abalone shell) to anchor Liver Yang and calm the head
Long Dan Xie Gan Tang (Gentiana Drain the Liver) — for acute Liver Fire migraines with intense unilateral pain, red eyes, bitter taste, and anger as a trigger; clears Liver and Gallbladder Fire and opens the Gallbladder channel
Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes and Gastrodia) — for Phlegm-Damp migraines with nausea, vomiting, dizziness and a heavy sensation in the head; one of the most clinically useful formulae for the Phlegm-Damp pattern that precisely matches the nausea-dominant migraine presentation
Xue Fu Zhu Yu Tang (Drive Out Stasis from the Mansion of Blood) — for chronic, fixed, stabbing migraines with Blood stasis; contains Chuan Xiong (Ligusticum), which is one of the most important single herbs for head pain in TCM; moves Blood and Qi in the head channels
Ba Zhen Tang (Eight Treasure Decoction) — for Qi and Blood deficiency migraines that are worse with fatigue and better with rest; tonifies both Qi and Blood to nourish the brain and raise the pain threshold
Chuan Xiong Cha Tiao San (Ligusticum and Green Tea Powder) — a classical formula specifically designed for head pain; particularly used for migraines involving external Wind invasion (triggered by weather changes, cold or wind); Chuan Xiong is its principal herb, with a well-established TCM tradition of being the key herb for all forms of head pain

Migraine sufferers can additionally benefit from supplements such as magnesium (which reduces cortical excitability and is often depleted in migraineurs), riboflavin (vitamin B2) and coenzyme Q10, all of which have evidence for migraine prevention. All herbs prescribed at this clinic are pharmaceutical-grade granule extracts supplied by Sun Ten (Taiwan), ensuring consistent potency and safety. An online Chinese herbal medicine consultation is available for those unable to attend in person.

7. Cupping therapy for migraines

Cupping therapy applied to the neck, upper back and occipital region is a valuable adjunctive treatment for migraines, particularly for patients in whom neck and shoulder tension is a prominent trigger or maintaining factor. Cupping releases tight fascial and muscular restrictions in the cervical and trapezius muscles, improves local circulation, and relieves the occipital and cervical tension that often precedes or accompanies migraine attacks. It is particularly effective for patients whose migraines are associated with pronounced neck stiffness, shoulder pain or upper back pain. In TCM, cupping at BL points along the upper back and at the base of the skull moves Qi and Blood, clears Wind and removes channel obstruction — directly addressing the blocked Gallbladder and Bladder channels that run through the occipital and temporal regions affected in migraine.

8. Self-care and lifestyle

Self-management is an important component of migraine treatment alongside acupuncture and herbal medicine. The most effective strategies include:

Migraine diary — keeping a detailed record of attacks (date, duration, severity, associated symptoms, possible triggers, medications taken) is essential for identifying individual triggers and monitoring the response to treatment. This is the foundation of personalised migraine management
Sleep regulation — maintaining consistent sleep and wake times is one of the most powerful lifestyle modifications for reducing migraine frequency; both too little and too much sleep are triggers. Addressing any underlying insomnia is an important part of migraine treatment
Dietary adjustments — identifying and avoiding personal food triggers; never skipping meals (hypoglycaemia is a potent trigger); staying well hydrated; reducing alcohol and excess caffeine. In TCM, reducing Phlegm-generating foods (dairy, refined sugars, fried foods, cold raw foods, alcohol) is particularly important for patients with the Phlegm-Damp pattern. Chinese food therapy guidance is provided based on the individual’s TCM pattern
Stress management — since stress is the most commonly reported migraine trigger, regular stress-reduction practices — including mindfulness, meditation, yoga, breathing exercises and regular acupuncture — directly reduce attack frequency
Regular exercise — consistent moderate aerobic exercise (avoiding sudden intense exertion, which can trigger attacks) reduces migraine frequency through its effects on cortical excitability, serotonin levels and stress hormones; maintaining a stable exercise routine rather than irregular bursts is key
Optimising work and rest patterns — reducing overwork, taking regular breaks from screens, managing working hours and maintaining energy reserves all reduce the frequency of Qi and Blood deficiency-type migraines in particular; in TCM terms, preserving Qi rather than exhausting it is central to long-term migraine prevention

9. Treatment at my clinic

I treat migraines at my clinic in Wokingham, Berkshire, combining acupuncture, Chinese herbal medicine and, where appropriate, cupping therapy in an individually tailored programme. Treatment for migraines is primarily preventive — the goal is to reduce attack frequency, severity and duration over time, so that migraines become less frequent and, when they do occur, are shorter and more manageable. Weekly sessions are advised initially, with a minimum course of six sessions; clinical research confirms that 7 to 16 sessions produce optimal results, with 16 or more sessions yielding the best long-term outcomes.

Chinese herbal medicine, taken daily between sessions, significantly enhances and extends the benefits of acupuncture treatment. Acute migraine attacks can also be treated with acupuncture when patients attend during an attack or in the prodrome phase. Visit the prices page for treatment costs. Related pages include acupuncture for headaches, acupuncture for stress, acupuncture for anxiety and acupuncture for insomnia.

10. Frequently asked questions

Can acupuncture prevent migraines?

Yes — acupuncture has a strong evidence base for migraine prevention. Multiple systematic reviews and meta-analyses confirm it significantly reduces attack frequency, duration and severity. A 2025 systematic review of 23 RCTs (2,295 patients) found acupuncture reduced migraine duration by over four hours per attack, reduced the number of attacks, and reduced migraine days compared with sham acupuncture — results that are not placebo effects. It is recommended by NICE as a prophylactic option for migraine sufferers who are unable to take or do not wish to take prophylactic drugs.

How many acupuncture sessions are needed for migraines?

Clinical research indicates that 7 to 16 sessions produce optimal results, with 16 sessions showing the greatest reduction in attack frequency (−3.95 attacks). A minimum course of six sessions is advised initially, delivered weekly. Attending three sessions per week has been shown to produce particularly rapid reductions in attack frequency. After the initial course, periodic maintenance sessions (monthly or as needed) help to sustain the gains and prevent the pattern from re-establishing.

Is acupuncture better than migraine medication?

The research consistently shows that acupuncture is at least as effective as prophylactic drug treatment (beta-blockers, amitriptyline, sodium valproate) for reducing migraine frequency, and produces better quality of life outcomes with far fewer adverse effects and contraindications. A 2024 network meta-analysis of 34 studies involving 3,365 patients found that acupuncture outperformed medication on pain intensity, attack frequency, attack duration and attack days. For acute treatment, acupuncture can also be used during attacks, including during the prodrome phase, to reduce the severity and duration of the episode.

Can Chinese herbs help with migraines?

Chinese herbal medicine is an important complement to acupuncture for migraine management, providing daily constitutional support that reinforces the effect of acupuncture between sessions. Formulae such as Tian Ma Gou Teng Yin (for Liver Yang rising), Ban Xia Bai Zhu Tian Ma Tang (for Phlegm-Damp migraines with nausea) and Xue Fu Zhu Yu Tang (for chronic stasis-type migraines) are specifically targeted at the TCM patterns that drive different migraine presentations. Combined treatment produces better and more sustained outcomes than acupuncture alone.

What is the TCM cause of migraines?

In traditional Chinese medicine, migraines are most commonly caused by Liver Yang rising from an underlying Liver and Kidney Yin deficiency, obstructing the flow of Qi and Blood in the Gallbladder and Liver channels that traverse the temporal and lateral regions of the head. Other patterns include Liver Fire, Phlegm-Damp obstructing the clear orifices (which drives the nausea and vomiting), Blood stasis in the head channels (in chronic cases) and Qi and Blood deficiency (producing migraines that resolve with rest and sleep). Treatment is individually tailored to the patient’s specific pattern, which is why TCM is particularly well suited to the diverse presentations of migraine.