NICE (the National Institute for Health and Care Excellence) says to consider a course of acupuncture for the prophylactic (preventive) treatment of chronic tension-type headache. For migraine, it says to consider a course if propranolol, topiramate and amitriptyline have not worked, are not tolerated or are unsuitable because of safety concerns, according to the person's preference, comorbidities and risk of adverse events. The full wording, including the length of course, is under "What the guidance and research say" below [4]. The NHS lists a sudden, extremely painful headache as a reason to call 999 (see below).
What headaches are
The NHS says most headaches go away on their own and are not a sign of something more serious. They can last 30 minutes, several hours, or sometimes several days [1].
Tension-type headache. The NHS says tension headaches are very common. Symptoms include pain on both sides of the head, face or neck, and a feeling that something is pressing on or tightening around the head [3].
Migraine. The NHS describes migraine as a condition that causes symptoms such as a severe headache, feeling sick and sensitivity to light. Attacks usually last between 4 hours and 3 days. The NHS says migraine cannot be cured, but treatment can help manage symptoms and prevent attacks [2].
What the guidance and research say about acupuncture
NICE guidance (CG150, last updated June 2025). NICE says:
- "Consider a course of up to 10 sessions of acupuncture over 5 to 8 weeks for the prophylactic treatment of chronic tension-type headache." [4]
- For migraine: "If propranolol, topiramate and amitriptyline have not worked or are not tolerated or are unsuitable because of safety concerns, consider a course of up to 10 sessions of acupuncture over 5 to 8 weeks according to the person's preference, comorbidities and risk of adverse events." [4]
The NHS. The NHS lists acupuncture among treatments to prevent migraine attacks, alongside medicines, relaxation techniques and cognitive behavioural therapy (CBT), and vitamin B2 [2].
NCCIH. NCCIH, part of the US National Institutes of Health, reports [5]:
- moderate-quality evidence that acupuncture may reduce the frequency of migraines, from a 2016 evaluation of 22 studies with almost 5,000 people
- that this evidence also suggests acupuncture may be better than sham acupuncture, but the difference is small
- moderate- to low-quality evidence that acupuncture may reduce the frequency of tension headaches, from a 2016 evaluation of 12 studies with about 2,350 people
- that a 2020 review of nine studies comparing acupuncture with various drugs for preventing migraine found acupuncture slightly more effective, and that people given acupuncture were much less likely than those given drugs to drop out because of side effects
Acupuncture in Malaysia
What acupuncture is. NCCIH, part of the US National Institutes of Health, describes acupuncture as a technique in which practitioners insert fine needles into the skin. The needles may be manipulated by hand or stimulated with small electrical currents (electroacupuncture). Acupuncture originated from traditional Chinese medicine [5].
Registration. Malaysia's Traditional and Complementary Medicine Act 2016 (Act 775) defines traditional and complementary medicine to include traditional Chinese medicine [6]. Under section 25 of the Act, in force since 1 March 2021, a person who is not a registered practitioner shall not practise traditional and complementary medicine services [6][7]. A registered practitioner must hold a valid practising certificate, which is valid for not more than twelve months and must be displayed at the place of practice (section 26) [6].
Referral. Section 30 of the Act requires a registered practitioner to refer a patient to a medical or dental practitioner if the patient has an acute medical emergency, or if the condition is beyond the practitioner's skill, competency or expertise [6]. Under section 30(3) the practitioner must explain this duty to the patient, or the patient's guardian or representative, so that they can make an informed decision about whether to refuse being referred. Section 30(4) says that if the patient, guardian or representative gives written notice consenting not to be referred, the practitioner is not obliged to refer [6].
NCCIH's guidance is not to use acupuncture to postpone seeing a health care provider about a health problem [5].
Safety. According to NCCIH, relatively few complications from acupuncture have been reported, but complications have resulted from nonsterile needles and improper delivery. When not delivered properly, acupuncture can cause serious adverse effects, including infections, punctured organs and injury to the central nervous system [5]. The NHS lists two situations in which acupuncture may not be safe: taking blood-thinning medicine or being at increased risk of bleeding, and having a skin condition or skin infection [8].
When the sources say to get medical help
Each source below sets its own level of urgency. Malaysia's emergency line is 999 [9]. The regulator's numbering plan also lists 112 as the code for mobile phones routed to emergency services [10].
Emergency. The NHS (UK) lists these as reasons to call 999 or go to A&E [1]. This is for a headache together with any of:
- a seizure (fit)
- numbness or weakness in the body or face
- a start that was sudden and extremely painful
- a head injury within the last 3 months
- difficulty speaking, balancing, walking or remembering things
- drowsiness or confusion
- loss of vision
- a rash that does not fade when a glass is rolled over it
- a very high temperature, a stiff neck, or bright lights bothering you
The NHS migraine page [2] also lists, for a migraine:
- "lose your vision, or have blurred or double vision"
- "cannot move or have weakness in the arms or legs on 1 side of your body, or 1 side of your face"
The NHS tension headaches page [3] also lists, for a headache that is extremely painful together with any of:
- sudden problems speaking or remembering things
- loss of vision
- feeling drowsy or confused
- a very high temperature and symptoms of meningitis
- the white part of the eye being red
For a child under 12 years old, the NHS tension headaches page also says to call 999 or go to A&E for [3]:
- "a headache with vision problems or difficulty speaking, swallowing, balancing or walking"
- "a headache with drowsiness or a persistent lack of energy"
- "a headache that starts within 5 days of a head injury"
The NHS says not to drive to A&E, and to ask someone to drive you or call 999 [1].
Urgent GP appointment or NHS 111 (NHS, UK) [1], for a headache together with any of:
- vision or eye problems (for a migraine, see the 999 list above for blurred or double vision)
- being triggered or made worse by coughing, sneezing, bending down or exercising
- being sick (vomiting)
- jaw pain when eating, or a sore or tender scalp
For migraine, the NHS also lists an attack that has lasted longer than 72 hours, aura symptoms lasting longer than 1 hour at a time, or being pregnant or having just had a baby [2].
See a GP (NHS, UK):
- a headache you have tried treating yourself that is not getting better or is getting worse [1]
- regular headaches [1]
- migraine attacks that are severe, getting worse, lasting longer than usual, or happening more than once a week [2]
- headaches several times a week, or severe tension headaches [3]
In Malaysia (Ministry of Health portals). Klinik Kesihatan Kuala Lumpur, a government health clinic, lists outpatient (Pesakit Luar) services. It lists its service hours as 8.00am to 5.00pm Monday to Friday, with extended hours on weekday evenings and on weekends and public holidays, and says it is closed on some festival days [11]. Hospital Kuala Lumpur's emergency department says it provides 24-hour emergency medical services to people in Kuala Lumpur [12].
Find a clinic
The clinic directory lists acupuncture and traditional Chinese medicine clinics across Malaysia by state and town.
Sources
- NHS. Headaches. Page last reviewed 17 April 2024.
- NHS. Migraine. Page last reviewed 10 March 2026.
- NHS. Tension headaches. Page last reviewed 1 August 2025.
- National Institute for Health and Care Excellence (NICE). Headaches in over 12s: diagnosis and management (CG150). Recommendations 1.3.9 and 1.3.21. Last updated 3 June 2025.
- National Center for Complementary and Integrative Health (NCCIH), US National Institutes of Health. Acupuncture: Effectiveness and Safety. Last updated October 2022.
- Laws of Malaysia. Traditional and Complementary Medicine Act 2016 (Act 775), English text published by the Ministry of Health Malaysia. Sections 3, 25, 26 and 30.
- Federal Government Gazette P.U. (B) 118, 23 February 2021. Appointment of date of coming into operation, Traditional and Complementary Medicine Act 2016.
- NHS. Herbal medicines and complementary therapies. Page last reviewed 1 May 2026.
- Malaysia.gov.my (MyGovernment portal). Malaysia Emergency Response Services (MERS) 999. Page updated 25 September 2025.
- Malaysian Communications and Multimedia Commission. Numbering and Electronic Addressing Plan, issued 26 January 2006. Schedule D.
- Kuala Lumpur and Putrajaya State Health Department, Ministry of Health Malaysia. Klinik Kesihatan Kuala Lumpur.
- Hospital Kuala Lumpur, Ministry of Health Malaysia. Kecemasan & Trauma.