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NCCIH Clinical Digest

for health professionals

Headaches and Complementary Health Approaches

June 2023
Woman at computer with a headache

Results of research on mind and body practices such as relaxation training, biofeedback, acupuncture, and spinal manipulation for headaches suggest that these approaches may help relieve headaches and may be helpful for migraines.

Several dietary supplements, including riboflavin, coenzyme Q10, and the herbs butterbur and feverfew, have been studied for migraine, with some promising results in preliminary studies.

Modality and Summary of Current Research

Butterbur contains pyrrolizidine alkaloids (PA), which are hepatotoxic. The American Academy of Neurology stopped recommending butterbur in 2015 because of serious concerns about possible liver toxicity. Some butterbur preparations have had PA toxins removed to ensure safety. Only butterbur products that have been processed to remove PAs and are labeled or certified as PA-free should be considered for use.

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There is some limited evidence that coenzyme Q10 may help reduce the duration and frequency of migraines but not their severity.

Read more about the research on coenzyme Q10 for headaches

Some research suggests that feverfew may help prevent migraine headaches, but results have been mixed. Some research suggests it may reduce migraine headache frequency, as well as some symptoms, such as pain, nausea/vomiting, and light sensitivity.

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Research on the use of magnesium supplements to prevent or reduce symptoms of migraine headaches is limited. 

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Overall, results of studies to date have found that riboflavin has similar efficacy to valproate for migraine prophylaxis but has a more tolerable side effect profile. 

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Diets high in omega-3 fatty acids may be helpful for migraines; however, omega-3s in supplement form have not been shown to reduce the frequency or severity of migraines.

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Results from studies indicate that acupuncture may help relieve headache pain, but that much of its benefit may be due to nonspecific effects including expectation, beliefs, and placebo responses rather than specific effects of needling.

Read more about the research on acupuncture for headaches

Many studies have tested biofeedback for tension headaches, and several evaluations of this research have concluded that biofeedback may be helpful. Studies have shown decreases in the frequency of migraines in people who were using biofeedback. However, it’s unclear whether biofeedback is better than a placebo for migraines.

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Only a small number of studies of massage for headache have been completed, and their results are not consistent.

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Some studies have found that relaxation techniques such as autogenic training or biofeedback-assisted autogenic training, hypnotherapy (and self-hypnosis paired with guided imagery) may help to reduce headache pain; however, the findings should be viewed cautiously because many of the studies have not been of high quality. 

Read more about the research on relaxation techniques for headaches

Spinal manipulation may be one of several complementary health approaches (including massage therapy) that’s as helpful as medications used for migraine prevention, but the research isn’t conclusive.

Read more about the research on spinal manipulation for headaches

Data are too limited to draw meaningful conclusions about whether tai chi is useful for tension headaches. 

Read more about the research on tai chi for headaches

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH, DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH’s Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH website at NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.


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