Dry Needling for Migraines
Dry needling for migraines
“Two days before a high-stakes event, neck tightness sets in; 12 hours later, a migraine follows.” The sequence is common. Many migraine presentations include a musculoskeletal cue—suboccipital pressure, temple banding, periorbital ache, or jaw clenching—before or during an attack. While migraine is neurologic and multifactorial, muscular trigger points in the neck, face, and scalp can add mechanical input to an already sensitive system.
Dry needling for migraines targets this mechanical component. The approach focuses on muscles known to refer pain to the forehead, temple, vertex, and periorbital regions. When the clinical picture includes neck or jaw tension, reducing trigger point irritability may lower overall nociceptive input and help decrease attack intensity or frequency.
Background on technique and what sessions involve is outlined in the Dry Needling Guide, and pain-referral maps appear in the Trigger Points Guide.
Key Points
Most suitable cases: migraine patterns that include neck or jaw tension, screen-time–provoked discomfort, or temple/periorbital pressure.
Primary effect: reduction of trigger point activity in specific neck–face–scalp muscles that commonly refer pain to the head and eye region.
Muscle coverage: a comprehensive, migraine-relevant set is assessed; treatment selection is based on the individual’s referral pattern and findings.
Expected timeline: noticeable change is often reported within 1–3 sessions; a short series of approximately 4–6 visits is common. Chronic patterns may require 10 or more visits or ongoing care.
Practical trial: 3–5 sessions (adjusted if responses are delayed or highly variable).
Session pacing: dosing remains conservative and is progressed according to comfort and symptom changes between visits.
Migraine: Brief Condition Overview
Migraine involves recurrent headache episodes with a characteristic constellation of features. Many presentations include a muscular component that contributes to the severity of each flare.
Signs & symptoms (common features):
Headache duration: typically 4–72 hours; unilateral or bilateral; pulsating or pressure-like sensation.
Sensory sensitivity: light and sound sensitivity are common; smell sensitivity may occur during flares.
Nausea or appetite change: may accompany the headache phase or the hours preceding it.
Aura (in some cases): visual changes (zig-zag lines, shimmering, blind spots), sensory changes (pins-and-needles), or speech difficulty preceding the headache.
Musculoskeletal cues: neck stiffness, temple banding, periorbital ache, or jaw clenching that appears before or during the headache phase.
Typical triggers: disrupted sleep, stress, dehydration, hormonal shifts, specific foods or additives, bright light, sustained visual tasks.
Typical treatment (commonly used approaches):
Acute headache strategies: triptans, gepants, ditans, NSAIDs, or combination agents used at the start of a flare to shorten duration and reduce intensity.
Preventive options: CGRP monoclonal antibodies, beta-blockers, antiepileptics, antidepressants, or supplements, selected according to pattern and tolerability.
Lifestyle & behavioral support: structured sleep schedule, hydration, consistent meals, trigger tracking, relaxation training, and graded activity.
Rehab and bodywork (when musculoskeletal drivers are present): dry needling, manual therapy, and targeted exercise to reduce neck/jaw/scalp muscle irritability and improve movement tolerance.
Migraine Trigger Points
Trapezius (upper fibers)
Why it’s important: Frequently tight with prolonged mouse/keyboard work; a common contributor when screen-time or desk posture precedes headache onset.
Referral pain zone: Temple, lateral head, or behind the eye.
Sternocleidomastoid (SCM)
Why it’s important: Often tender with clenching or shallow breathing; closely tied to “sinus-like” or front-of-face headache patterns.
Referral pain zone: Forehead, orbit (around the eye), ear, or cheek.
Temporalis
Why it’s important: Major temple contributor; sensitizes with bruxism, stress, and repetitive chewing/clenching.
Referral pain zone: Temple and fronto-temporal banding.
Splenius capitis & Splenius cervicis
Why they’re important: Frequently involved in “helmet-like” or crown pressure; can amplify light/sound sensitivity when irritable.
Referral pain zone: Vertex/crown and occipital-to-temporal arcs.
Suboccipital group
Why it’s important: Small upper-cervical stabilizers irritated by sustained viewing angles; common when screen-time precedes migraine.
Referral pain zone: Occiput, crown, and periorbital region (behind the eye).
Semispinalis capitis
Why it’s important: Interplays with suboccipitals and splenii; frequently present in stubborn vertex and posterior head pain.
Referral pain zone: Vertex/crown and posterior head.
Frontalis
Why it’s important: Contributes to forehead pressure or “band-like” tension, especially with habitual brow elevation.
Referral pain zone: Forehead and supraorbital band.
Zygomaticus & Orbicularis oculi
Why they’re important: Facial contributors that can intensify temple and periorbital ache in certain headache patterns.
Referral pain zone: Periorbital region and temple.
Platysma
Why it’s important: Superficial neck muscle that can contribute to diffuse aching across the lower face, jaw, and anterior neck, raising overall irritability.
Referral pain zone: Lower face, jaw line, and anterior neck.
How Dry Needling Fits Migraine with Neck/Jaw/Face Triggers
Dry needling is best considered when attacks reliably coincide with musculoskeletal drivers: skull-base stiffness prior to aura, temple tightness after prolonged laptop use, or periorbital ache associated with jaw clenching. In such cases, hyper-irritable trigger points can refer pain into regions already provocative during flares, creating a feedback loop that amplifies symptoms.
Treatment involves a thin, solid filiform needle applied to targeted neuromuscular tissue. A brief dull ache, a localized twitch response, or a familiar spread toward the temple or eye is common during needling and indicates accurate targeting. While a single tight muscle is not responsible for migraine, addressing muscular input can be materially helpful when neck or jaw tension is part of the clinical pattern. Additional technique context is provided in the Dry Needling Guide.
Migraine Pain Muscles Considered in Care
When history and examination suggest a muscle-driven component to migraine, the following migraine-relevant muscles are commonly evaluated. Treatment typically focuses on muscles that reproduce the individual’s referral pattern.
Trapezius (upper fibers) – frequently refers to the temple, lateral head, or behind the eye; often linked to prolonged mouse/keyboard tasks.
Sternocleidomastoid (SCM) – refers to the forehead, orbit (around the eye), ear, or cheek; commonly tender with clenching or shallow breathing patterns.
Temporalis – a major temple pain contributor; often sensitive with bruxism, stress, or repetitive chewing.
Splenius capitis & Splenius cervicis – associated with vertex/“helmet-like” distributions; can escalate photo/phonophobia.
Suboccipital group – small upper-cervical muscles that refer to the occiput, crown, and periorbital region; frequently irritated by sustained viewing angles.
Semispinalis capitis – linked with vertex and posterior head pain; interplays with suboccipitals and splenii.
Frontalis – implicated in forehead pressure or band-like tension, particularly with habitual brow elevation.
Zygomaticus & Orbicularis oculi – facial muscles that can intensify periorbital ache and temple pressure in select patterns.
Platysma – superficial neck muscle that may contribute to diffuse aching across the lower face, jaw, and anterior neck.
Selection is individualized. Muscles are palpated for taut bands and localized tenderness, then matched against the person’s headache map. Initial sessions typically address a small, high-yield subset to keep dosing comfortable and clarify what drives change. Illustrations of referral zones for these muscles are available in the Trigger Points Guide.
What to Expect in a Session (Comfort, Pacing, Soreness)
A typical visit begins with a concise review of migraine frequency, aura characteristics, predictable triggers, clenching habits, and any pre-attack warning signs. Cervical, jaw, and scalp motion are checked, followed by targeted palpation to identify taut bands and reproduction of familiar referral. The examination informs which muscles are addressed first and how many sites are suitable for the initial appointment.
During needling, a spreading ache or brief twitch may be noticed; these responses tend to settle within seconds. Sessions are kept short with gradual progression over time.
Post-session soreness commonly feels workout-like and can last 24–72 hours. Simple after-care—hydration and comfortable neck mobility—usually keeps this predictable and brief. A practical overview of session flow and common responses appears in the Dry Needling Guide.
Relief Timeline & Visit Cadence
Early change—such as reduced skull-base pressure, fewer warning twinges at the temple, or easier head rotation—is often reported within 1–3 sessions.
To influence overall attack frequency or intensity, a short series of approximately 4–6 sessions is common.
Chronic patterns, particularly with long-standing muscular contributors or frequent migraines, may require 10 or more visits or ongoing care at a lower maintenance frequency. Spacing is adjusted to sensitivity and schedule (weekly or slightly longer intervals are typical).
Progress is tracked against meaningful markers: number of “bad days,” reliance on abortive agents, or post-flare recovery time. If these metrics are unchanged after a 3–5 session practical trial, treatment variables are adjusted (e.g., alternate muscle priorities, dosing, or visit spacing) or further evaluation is considered. The plan remains outcome-driven, with modifications based on symptom records and calendar realities.
Dry Needling for Migraines Research
Expert Consensus on Dry Needling Practices for Headache (2025)
A recent expert consensus review analyzed nearly 200 randomized controlled trials on dry needling, finding short-term pain reduction across musculoskeletal conditions and specifically reporting clinical benefit for headache—including migraine—in all eight studies reviewed. Dry needling was shown to reduce pain intensity compared to sham or placebo, though it was not statistically superior to other interventions. Importantly, this consensus highlighted the need for more consistent dry needling protocols in migraine research to further validate and optimize clinical outcomes. For actionable research protocol guidance and up-to-date efficacy details, see this expert clinical review of dry needling for headache management dry needling for migraines expert consensus.
Dry Needling Into Sternocleidomastoid Trigger Points for Migraine: Controlled Clinical Trial (2021)
This randomized controlled trial evaluated dry needling into myofascial trigger points of the sternocleidomastoid muscle in migraine patients and found significant improvement in headache frequency, intensity, and duration immediately and at one-month follow-up. The treatment group also showed increased pressure pain threshold and cervical range of motion. This study supports the targeted use of dry needling for clinically verified migraine patterns with neck muscle involvement, offering evidence-based options for muscular pain modulation in migraine neck muscle dry needling for migraine.
Systematic Review and Meta-Analysis of Dry Needling for Migraine, Tension-Type, and Cervicogenic Headache (2019)
A systematic review assessed the effectiveness of dry needling for various headache types, including migraine, and concluded that dry needling was efficient for short-term pain relief and for reducing headache-related disability. Physiological mechanisms include peripheral pain modulation and activation of central inhibitory pathways. The review further noted that dry needling is a low-risk and easy-to-perform procedure for migraine management with very few adverse events, making it accessible within multidisciplinary headache care. Details on the mechanism and procedural considerations can be found in the systematic assessment of dry needling for headache and migraine dry needling systematic review.
Frequently Asked Questions (FAQ)
Can dry needling help migraines?
It can be helpful when a muscle-driven component is evident in a migraine pattern—e.g., consistent neck/jaw/face tension that precedes or accompanies attacks and is reproducible on examination. In such cases, reducing trigger point activity may lower the mechanical input that aggravates symptoms.
How many sessions are needed before results are clear?
A practical trial is 3–5 sessions. Some individuals notice change sooner, while others require a short series to shift frequency or intensity. If progress is not observable in tracked metrics, treatment variables are revised accordingly.
Ready to Try Acupuncture & Dry Needling?
Whether you’re struggling with acute or chronic pain, acupuncture and dry needling may help restore mobility and reduce pain - quickly and safely.
📍 Conveniently located in New York City
🧠 Experts in trigger point therapy, acupuncture, and dry needling
Book your appointment today with the experts at Morningside Acupuncture, the top-rated acupuncture and dry needling clinic in New York City.
Let us help you move better, feel stronger, and live pain-free.
Additional Resources & Next Steps
Learn More: Visit our Blog for further insights into our treatment approach.
What to Expect: During your initial consultation, we perform a comprehensive evaluation to develop a personalized treatment plan.
Patient Stories: Read testimonials from patients who have experienced lasting relief.
Sources:
Wong, C., et al. (2025). Expert Consensus on Dry Needling Practices for Headache. Frontiers in Oral Health, 4, Article 1524496. https://pmc.ncbi.nlm.nih.gov/articles/PMC11900175/
Madani, S. P., et al. (2021). Effects of Dry Needling Technique Into Trigger Points of the Sternocleidomastoid Muscle in Migraine Headache Patients: A Randomized Controlled Trial. Archives of Physical Medicine and Rehabilitation, 102(12), 2320-2327. https://pubmed.ncbi.nlm.nih.gov/32544109/
Lu, W., et al. (2019). Effectiveness of Dry Needling for Improving Pain and Disability in Patients With Tension-Type Headache, Cervicogenic Headache, and Migraine: A Systematic Review and Meta-Analysis. Journal of Pain Research, 12, 2665-2681. https://pmc.ncbi.nlm.nih.gov/articles/PMC6761714/
Disclaimer: This web site is intended for educational and informational purposes only. Reading this website does not constitute providing medical advice or any professional services. This information should not be used for diagnosing or treating any health issue or disease. Those seeking medical advice should consult with a licensed physician. Seek the advice of a medical doctor or other qualified health professional for any medical condition. If you think you have a medical emergency, call 911 or go to the emergency room. No acupuncturist-patient relationship is created by reading this website or using the information. Morningside Acupuncture PLLC and its employees and contributors do not make any express or implied representations with respect to the information on this site or its use.
Read more from our blog
