Tension-type headache (TTH) is one of the most common forms of headache, often related to muscle tension and stress. Many patients seek acupuncture as a non-drug treatment option, but its effectiveness has been debated. This Cochrane systematic review (updated in 2016) evaluated the scientific evidence on whether acupuncture can help prevent frequent or chronic tension-type headaches.

Study Overview
- Included Studies: 12 randomized controlled trials (total of 2,349 participants)
- Comparisons Made:
- Acupuncture vs. routine care or acute treatment only
- Acupuncture vs. sham (placebo) acupuncture
- Acupuncture vs. physiotherapy, massage, or exercise
Key Findings
- Compared with routine care:
Acupuncture significantly reduced headache frequency.
About 45–48% of patients receiving acupuncture reported at least a 50% reduction in headache frequency, compared to 4–19% in control groups. - Compared with sham acupuncture:
Acupuncture showed a modest but meaningful benefit.
51% of patients improved by at least 50%, compared to 43% with sham treatment (Risk Ratio 1.3; 95% CI 1.09–1.5). - Compared with other therapies:
When compared to physiotherapy, massage, or exercise, acupuncture showed similar effectiveness. - Safety:
Very few participants dropped out due to side effects, indicating that acupuncture is a safe and well-tolerated treatment.
Overall
Current evidence suggests that acupuncture is effective and safe for reducing the frequency of tension-type headaches, particularly for people with frequent or chronic symptoms. However, more high-quality studies are needed to directly compare acupuncture with other preventive treatments.
Acupuncture offers a valuable non-drug option for managing chronic tension-type headaches, improving quality of life with minimal side effects.
References
- Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews. 2016 Apr 19;(4):CD007587. doi: 10.1002/14651858.CD007587.pub2