Acupuncture for headaches
How do biomedicine and Chinese medicine view the root cause of headaches and migraines?
Cephalgia, better known as headache, is one of the most common neurological symptoms in adults aged 18-65. According to the World Health Organization, approximately 50% of people across the globe experience recurrent headaches, and 30% or more report experiencing migraines. (1) The study of headaches and diseases of the head covers a wide sphere in terms of disciplines and medical specialties. Yet much of the data available does not take into account the occurrence of headaches as a secondary or accompanying symptom. With growing rates of auto-immune disease, elders who are living longer with declining health, as well as young people who experience impediments to wellness, surely there is more to research to pursue.
In biomedicine, the three common types of headaches, are tension headaches, cluster headaches, and sinus headaches. (2) Additionally, medication overuse headache is a headache type that has become common in modern diagnostics. Each type shares a common thread in that most present as persistent and some are recurring, which is most commonly seen in migraines. In addition, women who menstruate are more likely to experience headaches and migraines compared to others, in large part due to hormonal fluctuations.
Headaches and migraines are often used to describe pain present in the head and upper neck, but it is helpful to understand the difference between them. As described, headaches can occur as a symptom of an underlying issue — not all headaches are migraines. Migraines are a neurological condition characterized by minor seizure-like activity in the brain. They are often experienced as a throbbing-type pain that manifests on one side of the head and can last several hours to a few days. Due to the changes in brain activity that affect blood flow in the brain and surrounding tissues, there are a range of other symptoms involved including nausea, vomiting, light/sound/smell sensitivity, visual disturbances (auras or flashes), dizziness, and fatigue. (2) Migraines can have a genetic cause, but not always. In other cases, someone can develop a pattern of migraines with no prior family history.
In Chinese medicine, the head is closely related to the sky or heaven, as it is the most proximal area of the human body. The head is also a place where many blood vessels and collaterals meet, helping to maintain connection and communication throughout the body. (3) The natural flow of blood and energy moves upward, which can leave this area of the body (including the head, neck, and face) quite vulnerable in the face of changing climatic factors, both internally and externally. Chinese medicine utilizes a pattern differentiation framework to distinguish headache types and assess the level or stage of the primary disease causing the neurological change.
When a pathogenic wind invades the human body, it first attacks the upper portion of the body. (3)
There are three core etiological sources of headache and migraine.
Invasion of pathogenic wind into the upper part of the body. Pathogenic wind can take several forms including cold, summer-heat, heat, dry, and damp. The invasion of wind is often due to sudden or usual changes in the weather or exposure to poor air quality. This can damage or obstruct the orifices in the upper body, leading to blockages that may be concurrent with opportunistic infectious agents (viral, bacterial, fungal, or parasitic).
If a person is more active and energetic, tends to experience anger or frustration, or finds it challenging to manage their temper, they likely express a Yang-type of personality. They may also experience frequent spikes in emotional or physiological reactivity causing injury to bodily energy via stagnation or depletion. This would, in turn, damage the Yin, or vital fluids and nutrients within the body that help to deliver core neurotransmitters including dopamine and serotonin, which regulate feelings of pleasure and well-being.
Headaches may also be due to reasons of extreme deficiency. If someone is overworked, stressed, consuming harmful foods and substances, or has poor health practices, this will lead to compromised immune system function. When energy is blocked and circulation is compromised, headaches are likely to develop. This also applies in cases where there is the presence of a chronic disease or a congenital deficiency.
Evidence-based research shows promising results for headaches and migraines. A clinical trial regarding acupuncture in patients with headaches shows that groups who receive acupuncture in combination with routine care are associated with marked clinical improvements compared to those who did not receive acupuncture. (4) Specifically, this study confirmed a decreased number of days of pain from a headache, along with improved quality of life. Another clinical trial led by researchers from the Qingpu Hospital of Traditional Chinese Medicine compared manual acupuncture and electroacupuncture treatment protocols. The results of this two-year study indicate that electroacupuncture stimulation is often more effective for pain relief for migraine patients. (5)
The rise in headache-related issues is, in many ways, symbolic of what is happening across the globe within larger ecosystems. The world’s winds are speeding up amidst long-term global warming, and extreme fires consume acres of land. This leaves both human and non-human communities vulnerable to experiencing displacement and further compromises ecologically stable environments. We are a part of nature, and our bodies are unique ecosystems. Through a functional approach, acupuncture and Chinese medicine can be a helpful ally to those who experience headaches and migraines as a disruption to their internal ecology.
References
World Health Organization. “Headache Disorders”. WHO, 2016.
Penn Medicine. “Migraine vs. Headache: How to Tell the Difference”. Penn Medicine Health and Wellness, 19 Nov 2019.
Cheng Xinnong. “Chinese Acupuncture & Moxibustion”. Foreign Language Press, 2012.
Jena S, Witt CM, Brinkhaus B, Wegscheider K, Willich SN. Acupuncture in patients with headache. Cephalalgia. 2008 Sep;28(9):969-79. doi: 10.1111/j.1468-2982.2008.01640.x. Epub 2008 Jul 8. PMID: 18624803.
Hu Tiantian, Shen Lihua, Zhang Hui, Li Lechen. Clinical Effects of Electroacupuncture Combined with Cerebral Circulation Treatment for Liver-yang Hyperactivity Migraine. Journal of Navy Medicine, Vol. 42, No. 5, Sep, 2021.