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Migraine - which complementary medicines work and which don't?

Professor of complementary medicine Professor Edzard Ernst and colleagues continue our series on which therapies work, which don’t and which might cause harm – this time in migraine prophylaxis

Professor of complementary medicine Professor Edzard Ernst and colleagues continue our series on which therapies work, which don't and which might cause harm – this time in migraine prophylaxis

Many patients with migraine have tried complementary and alternative therapies, particularly herbal medicine, spinal manipulation, acupuncture, homeopathy or reflexology. The focus of this evidence review is on prevention of migraine rather than treating an acute attack.

Clinical bottom line

Beneficial

• Biofeedback Reduces migraine frequency and improves self-efficacy.

Likely to be beneficial

• Relaxation Seems to be useful for adults alone or in combination with biofeedback.

Unknown effectiveness

• Acupuncture: May improve symptoms and number of migraine days but data often contradictory and methodologically weak.

• Butterbur (Petasites hybridus): Preliminary data suggest reduction of attack frequency.

• Co-enzyme Q10: Not enough data available.

• Feverfew: May reduce frequency or severity of pain but data contradictory.

• Fish oil: Not enough data available.

• Massage: Preliminary data suggest reduction of frequency and improvement of sleep quality.

• Yoga: Not enough data available.

Unlikely to be beneficial

• Homeopathy: Best evidence fails to show positive effects.

Likely to be ineffective or harmful

• Spinal manipulation: Not enough effectiveness data available. Upper spinal manipulation has been associated with stroke and death.
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Conclusions

Biofeedback prevents migraine attacks. The evidence for relaxation is encouraging but more data are required to be sure. When used correctly, biofeedback and relaxation are not associated with serious or frequent harm. For biofeedback the risk-benefit balance seems positive; it is likely to be positive for relaxation. Biofeedback has been shown to be similarly effective to propanolol.


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Professor Edzard Ernst is professor of complementary medicine at Peninsula Medical School, Universities of Exeter and Plymouth.

Dr Max Pittler is senior research fellow in complementary medicine.

Barbara Wider is research fellow in complementary medicine.

Kate Boddy is information officer in complementary medicine.

This is an extract from the Oxford Handbook of Complementary Medicine, which offers evidence-based analysis of therapies

ISBN 978-0-19-920677-3

migraine box evidence Accupuncture - may improve symptoms and number of migraine days but data often contradictory and methodologically weak Accupuncture

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