Headache and Migraines
According to the theory of traditional Chinese medicine, migraine headaches and headaches in general can be considered as syndromes of meridians. The meridians that reach the head are the Gall Bladder and San Jiao channels of the foot/hand Shaoyang, Large Intestine and Stomach channels of the hand/foot Yangming, and Urinary bladder and Small intestine channel of the foot/hand Taiyang. Treatment is according to the channels affected. Headaches present as either a diffuse or regional area of pain. Headaches rarely are due to life threatening conditions such as a brain tumor but further evaluation may be necessary.
For clinical purposes the International Headache Society (IHS) divides headaches into 2 broad categories: primary headaches and secondary headaches.
Primary headaches, which are headaches with no organic or structural etiology, include: vascular (migraine) headache, trigeminal autonomic cephalalgias headache: pain in the head caused by dilation of cerebral arteries or muscle contractions or a reaction to drugs (which includes cluster headache), tension headache, and other secondary headaches examples include: hemicrania continua is a persistent unilateral headache that responds to indomethacin. Hemicrania continua is considered a primary headache disorder, meaning that it's not caused by another condition, new daily persistent headache, exertional headache, hypnic headache a headache that induces sleep, thunderclap headache is a headache that is severe and sudden like a thunderclap it may be the result of bleeding in the head a sign of a medical emergency, immediate medical attention must be considered.
Secondary headaches are those due to an underlying structural or organic disease that include: Head trauma, cardiovascular disorders, substance abuses, medication side effects, metabolic disorders, ear, nose, eye, neck, cranium disorders, cranial neuralgias, hypertension, and psychiatric disorders. Disorders in respiration can also be classified here since inadequate breathing and breath holding prevent the free flow of cerebral spinal fluid (CFS) circulation.
The different type headaches are defined by the channel affected and the pathology present. The primary exterior pathogen is WIND. Think of wind in the context of the environment, it moves rapidly upward swiftly, wind stirs up things, and it is the primary way in which other external pathogenic factors enters the body.
Exterior factors are: Wind-Cold, Wind-Heat, and Wind-dampness. These all obstruct the free flow of yang Qi, and blood in the head.
Interior factors are caused by disorders of the Spleen (accumulation of phlegm/damp), Liver (liver fire or deficiency fire stirring upwards), and Kidney (essence deficiency due to malnourishment).
Diagnosis is made by eliciting relevant symptoms i.e., stabbing pain is a blood stasis headache, an empty type headache is due to kidney essence deficiency, a phlegm/damp type headache feels like a heavy wet towel covering the head. These are just a few examples.
Diagnosis is also made by identifying the channel(s) affected. Examples are a Taiyang headache originates at the back of the head and down the neck, Jueyin headache affects the eyes and the top of the head.
Exterior type headaches come on suddenly is severe and has pain that is sharp, throbbing, burning, distending, is heavy and constant. Interior derived headaches are gradual, mild, with pain that is dull, empty feeling, lingering, worse with activity, and intermittent.
As with all pain in the body if there is a blockage to the free flow of qi and blood pain will ensue. Treatment principals are to clear the external pathogen and tonify (strengthen) the internal deficiency. Acupuncture and Chinese herbal medicine is effective to achieve a favorable outcome.
Headaches are usually caused by muscle tension, vascular problems, or both. Common triggers of vascular headaches are stress, heat, or a lack of sleep or food. Migraines appear to be vascular in origin, and may be preceded by visual disturbances, loss of peripheral vision, and fatigue. The causes of migraine headaches are still under investigation. Most headaches can be relieved or ameliorated by Chinese Medicine and Acupuncture and or the integration of western therapies.
The Chinese Medicine Classification of headache is very extensive. In western medicine there are either headaches or migraines. In Chinese medicine as described above can be caused by many factors. In order to get a complete picture of your headache type/cause many factors are looked at such as lifestyle, familial constitution (genetic predisposition), and environmental factors, internal condition of the organs and channels, emotional and physical stressors. Even the foods you eat and soap you use is taken into consideration.
The specific location of the headache this is important because the location points to a channel and or organ system that is out of balance. For example if you get a headache always on the forehead area it maybe that there is something going on with the center of digestion (the Spleen/Stomach) or the Spleen/Stomach channel is blocked.
Chinese medicine helps headaches by relieving the blockage of vital energy or Qi and blood. By moving the Qi the Blood follows where the blood goes so does nourishment. Acupuncture directly affects the central nervous system. Chinese medicine looks for the root cause of the headache and attempts to correct this.
Proper treatment of any type of pain requires a careful evaluation of the type of disharmony (excess or deficiency, cold or heat, exterior or interior), characteristics (qi and/or blood stagnations), and locations (upper body, lower body, extremities, or internal organs). Treatment utilizes an integrative use of herbs, acupuncture and Tui-Na (special Chinese massage) therapies, meditation, increased physical activities, and dietary changes. All these therapies work together to tonify (strengthen) the underlying deficiencies, strengthen the body, and facilitate recovery.
TCM pain management targets both the symptom (branch) and the cause (root) of pain, and often achieves immediate and long-term success.
TCM pain management is associated with few or no side effects. In some cases, such as acute, excruciating migraine, drugs are superior to herbs or acupuncture, as they have an immediate rapid onset of action (especially if given via injection). Treatment may require the integration of allopathic medicine to treat acute pain, and herbal medicine and acupuncture to provide long-term healing of underlying causes and prevent recurrence of migraines.
Common causes of headache include:
- Sinus disease
- Dental issue
- TMJ or TMD
- Pathology of the ears
- Muscular injuries
- Cervical spine issues
- Emotional stress
- Eye strain
- Trigeminal neuralgia
- Head injury
Reference:The design and protocol of acupuncture for migraine prophylaxis: A multicenter randomized controlled trial
Cochrane Data Base: Acupuncture for migraine prophylaxis
Migraine patients suffer from recurrent attacks of mostly one-sided, severe headache. Acupuncture is a therapy in which thin needles are inserted into the skin at defined points; it originates from China. Acupuncture is used in many countries for migraine prophylaxis – that is, to reduce the frequency and intensity of migraine attacks.
Collectively, the studies suggest that migraine patients benefit from acupuncture. Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.
Clinical Manual of Oriental Medicine. 2nd Edition by Dr. John Chen PharmD
Essentials of Chinese Medicine Internal Medicine By Anshen Shi ©2003
Biomedicine A Textbook for Practitioners of Acupuncture & Oriental Medicine By Bruce H. Robinson, MD ©2007
Medicine Edited by Allen R. Myers - 4th Edition ©2001 Lippincott Williams & Wilkins The National medical series for independent study