Acupuncture for Migraine in San Francisco

Migraine, tension-type and cluster headaches need different care

The diagnosis matters before choosing a treatment. These features help distinguish common headache types; they do not replace a medical assessment.

Tension-type headache

Dull pressure on both sides of the head
Feels like a tight band around the skull
Common with stress and poor posture

Migraine

Usually one-sided, throbbing pain
Sensitive to light and noise
Often comes with nausea

Cluster headache

Severe pain fixed around one eye
Watery eye and a blocked nose, same side
Attacks are extremely intense but short

Cluster headache needs a specific medical treatment plan. A sudden severe headache or a headache with new weakness, confusion or fever needs urgent medical assessment. NICE headache guidance.

The location of your headache helps guide point selection

I use the location of the pain alongside your sleep, digestion, menstrual cycle and examination findings to choose acupuncture points.

Chinese medicine groups these locations into channels. The table shows that traditional framework, not separate neurological diagnoses or a test for the cause of migraine.

Where the pain is	Other symptoms I ask about
Temple and the side of the headShaoyang	A bitter taste, sighing, sweating, discomfort in the ear, throat or cheek, tightness under the ribs.
Forehead and browYangming	Nausea, vomiting, an unsettled stomach.
Back of the head and the neckTaiyang	Eye pain, eyes watering in wind, a blocked or running nose, pain travelling down the neck and upper back.
Top of the headJueyin	Palpitations, a tight chest, mood swings, hot palms.

Typical acupoints for migraine, grouped by head, hand and foot, labeled with the Shaoyang, Yangming, Taiyang and Jueyin channels they belong to

Sleep, digestion and fatigue also shape the treatment

These traditional pattern names describe combinations of symptoms. They help organise the treatment; they do not mean you have liver disease, a blood clot or another medical diagnosis.

What the pain feels like	What else is going on	What it tells me
Distending and throbbing, usually one side, worse under pressure	Irritability, broken sleep, tension held in the jaw and shoulders.	Rising liver yang: a traditional pattern associated with tension and agitation.
Heavy, muzzy and dull, like a cloth wrapped around the head	Nausea, fullness, heaviness after eating, foggy thinking.	Phlegm turbidity: a traditional pattern associated with heaviness and digestive symptoms.
Sharp and stabbing, severe, fixed in the exact same spot every time	Sometimes an old head or neck injury, sometimes nothing obvious.	Blood stasis: a traditional description of fixed, sharp pain.
Milder but constant, worse after exertion	Fatigue, pallor, poor appetite, waking unrefreshed.	Qi and blood deficiency: a traditional pattern associated with fatigue and poor recovery.

The first visit connects your headache history with a physical examination

Bring your headache diary and medication list

We review attack frequency, sleep, work, digestion and stress. If attacks track your menstrual cycle, that matters too. I then examine the neck, shoulders and abdomen for tenderness and tension.

A headache diary gives us a baseline: migraine days, attack severity and use of rescue medication. We use those measures to judge the treatment over time.

Cheek acupuncture uses a few shallow needles

A standardised map of points on each cheek, needled shallowly, a few at a time, to treat pain elsewhere in the body. It is not cosmetic facial acupuncture. Most describe it as lighter than ordinary needling, because the needles are shallow and few.

I hold the Level 3 certificate in cheek acupuncture. We may discuss it as part of your treatment, but evidence from other pain conditions does not establish how well it treats migraine.

How cheek acupuncture works

FSN needling may be useful when neck and shoulder tension is part of the problem

Illustration of the muscles of the upper back seen from behind, with an FSN needle entering at the top of the shoulder. An enlarged cross-section beside it shows the needle lying flat in the myofascial layer between the skin and the muscle. — FSN needling stays in the tissue beneath the skin, above the muscle.

Cross-section of skin comparing two needles. A traditional acupuncture needle goes straight down through epidermis, dermis and myofascial layer into the muscle. The FSN needle enters at a shallow angle and stops in the layer above the muscle. — FSN needling stays in the tissue beneath the skin, above the muscle.

FSN is Fu's Subcutaneous Needling, developed in China in the mid-1990s. The needle goes in at a shallow angle and stays in the loose layer under the skin, above the muscle. I sweep it gently side to side while guiding you through specific movements, and reassess how the area moves. I hold the FSN certificate.

I use it for associated muscle tension and re-test your neck or shoulder movement during the visit.

Relief of muscle tension is different from preventing migraine. The migraine research below concerns conventional acupuncture, not FSN or cheek acupuncture.

How FSN needling works

Research on migraine

The strongest case for acupuncture is reducing recurring attacks

A 2020 trial in 150 people with episodic migraine without aura compared manual acupuncture, sham acupuncture and usual care. After 20 sessions over eight weeks, the acupuncture group had a greater reduction in migraine days than the sham group during follow-up.

At weeks 17 to 20, migraine days per four weeks had fallen by 3.9 with acupuncture and 2.2 with sham treatment. That is a group average from a specific treatment schedule, not a prediction of your result. Read the BMJ trial.

UK NICE guidance includes up to ten acupuncture sessions over five to eight weeks when propranolol, topiramate and amitriptyline have not worked, are not tolerated or are unsuitable. That recommendation concerns prevention, rather than a promise to stop an attack on the table. Read the migraine recommendations.

Keep an attack plan while we work on prevention

Goal	What we coordinate
Treat an attack	Keep the rescue plan agreed with your prescriber. Acupuncture does not replace access to acute migraine treatment.
Reduce future attacks	Discuss acupuncture alongside preventive options with your clinician. Track migraine days and medication use across the course.
Review the response	Bring your diary to reassessment. If the treatment is not helping, we change the plan or stop; medication changes stay with your prescriber.

Frequently Asked Questions

Does it hurt?

Less than people expect. The needles are about the width of a human hair, and I use fewer of them than most practices. Most people describe a dull heaviness at the point rather than pain, and a fair number fall asleep on the table.

How soon will I know if it is working?

We look for a change across several visits, using your headache diary to track attack frequency, severity and rescue medication. A looser neck during a session can be useful, but it does not by itself show that migraine is improving.

A course is around ten sessions. We track it against your headache diary rather than against how you feel on the day, and if nothing has moved by the reassessment I will say so and we stop.

I tried acupuncture before and it did nothing. Why would this be different?

A previous course may have differed in technique, frequency or treatment goals, and acupuncture does not help everyone. Bring what you remember about that treatment and your headache history. We can discuss whether another trial has a clear purpose and how we would judge it.

Do I keep taking my medication?

Yes, unless the person who prescribed it says otherwise. I do not adjust prescriptions and nothing here is a reason to stop one. If reducing your medication is the goal, that is a conversation with your prescriber, and I am glad to write to them with what I am seeing.

Is it safe during pregnancy?

Tell me if you are pregnant so we can review whether treatment is appropriate and coordinate with your OB. A new or changed headache during pregnancy needs medical assessment before it is treated as your usual migraine.

How many needles?

Fewer than you are imagining. Point selection is deliberate and minimal, and most people are surprised how little is used. Where they go depends on what the exam finds rather than on where the pain is, and I talk you through it before anything happens. If needles worry you, say so and we will discuss a gentler starting point.

What does it cost?

The first consult is free. A new patient visit is $255 for 75 minutes and follow-ups are $205 for 60 minutes. Current rates are on the pricing page.