About Headaches
Nearly everyone will suffer from headaches at some point in time. They are one of the most common physical complaints that prompt people to treat themselves or seek professional assistance.
Simply defined, a headache is a pain in the head due to some cause. Headaches may result from any number of factors, including tension; muscle contraction;
vascular problems; withdrawal from certain medications; abscesses; or injury.
Headaches fall into three main categories:
Tension-type, migraine and cervicogenic. Tension-type headaches are the most frequent. Patients who endure tension-type headaches usually feel mild to moderate pain on both sides of the head. The pain is usually described as tight, stiff or constricting, as if something is being wrapped around your head and squeezed tightly.
Cervicogenic headaches are the most recently diagnosed type of headache and are musculoskeletal in nature. They may be caused by pain in the neck or spine that is transferred to the head. Many times, cervicogenic headaches go undiagnosed because of their recent classification.
Heacaches can be very distracting and account for significant amounts of time lost from work.
If you are a headache sufferer, your obvious concern is to obtain safe, dependable relief. You should avoid making things worse by using drugs – even over-the-counter, non-prescription drugs – that can have serious side effects and dangerous interactions with other medications or supplements that you might be taking. You should also be aware that many people experience what are termed Analgesic Rebound Headaches from taking painkillers every day, or nearly every day. The medicine you take to get rid of today’s headache may give you a headache tomorrow and the days after, due to the gradual build-up of some of the compounds found in today’s headache relief tablets.
More than 90 percent of headaches can be classified as Tension-type, Migraine, Cervicogenic or Cluster.
Common headache pain is caused by vasoconstriction (narrowing of blood vessels). Because this is not well understood, even by pharmacists and doctors it seems, common medications prescribed for headaches (e.g. beta blockers which dilate blood vessels) can make migraines worse.
Migraine can be life threatening, preceding strokes, aneurysms, permanent visual loss, severe dental problems, epileptic seizures, coma and even death. It also greatly impacts job productivity, personal and social relationships.
Tension-type headaches are the most common and frequent.
Migraines are periodic, severe, throbbing headaches that afflict far fewer people than tension-type headaches, and are usually more frequent in women than men. These types of headaches usually hurt on one side of the head, can cause loss of appetite, nausea and even vomiting, and may involve temporary visual changes.
Cervicogenic headache is a musculoskeletal form of tension-type headache (which may also be related to migraines). Often, cervicogenic headaches go undiagnosed, and this is at least in part, due to the relative newness of this classification.
Cluster headaches occur most often in men, and are characterized by excruciating pain in an eye or a temple, and last from 15 minutes to an hour or more. They occur in waves lasting weeks to months, and occurring once or twice a year.
Western Medical View
Western medicine focuses on pain management by prescribing painkillers. We would normally advise patients to see their GP first in order to clarify the diagnosis. Those who have already been investigated by their GPs or consultants can bring the results of the investigations, such as reports of MIR scan or any blood tests to their Chinese Medical doctor.
When a headache hits, it can be triggered by a number of factors. These triggers act on people with a genetic disposition toward irregular serotonin control. It is thought that a trigger causes a wave of electrical activity to spread through the brain. The serotonin level then surges in a kind of a wave action. A result is that decreases in serotonin can cause blood vessels to become irritated, and maybe the trigeminal nerve (a major nerve in the brain/face) as well. The result is a headache and associated pain.
Many sufferers of chronic headaches increase their susceptibility by over-medicating, which can lead to rebound headaches. Rebound headaches are more frequent headaches which are the result of too much pain relief medication; where too much can be the amount of caffeine contained in three or four cups of coffee per day, or in more than twice weekly doses of pain relievers or decongestants; or even two aspirins a day and some caffeine.
It is important to use medications sparingly by tolerating as much pain as you can. A person may find that something like Aleve, Advil, aspirin, or Tylenol may effectively reduce headache pain, which can lead to more frequent use, which may then cause more frequent headaches. And, the medication of choice tends to become less effective, causing one to increase the frequency of its use in a kind of an endless circle.
It should be emphasized that emotions such as stress, worry, depression, etc. can also act as triggers to headaches and migraines. It is therefore essential to maintain good emotional balance, even if that means some form of psychotherapy. Foods are often mentioned as significant triggers, but their importance is much less relevant in the face of stress and biochemical imbalances.
If all else has failed, you may decide to turn to preventive medication with a physician’s assistance (see below). You may choose to follow this path if:
- You get moderate to severe migraines more than three times per month
- Migraine relief has so far failed
- The frequency or intensity of your migraines is adversely affecting your quality of life
The following medications probably won’t eliminate your migraines, but could improve the quality of your life:
- Antidepressants
- Beta Blockers
- NSAIDs
- Calcium Blockers
If you still do not find relief, a doctor might prescribe combinations of previously identified medications.
As a last resort, there is a group of drugs called MAO Inhibitors (like Nardil). These drugs are helpful for both migraines and simple daily headaches. While these drugs can be very helpful, along with the drugs comes a long list of foods and other drugs to avoid when taking them. Your doctor will advise.
Chinese Medical View
Acupuncture has been proved to be an effective treatment for headache through clinical trials*.
Chinese medicine has a very consistent framework for headache aetiology, physiology, diagnosis and treatment strategy. Acupuncture has been applied to headaches from the earliest beginnings of Chinese Medicine.
According to Chinese Medicine theory acupuncture can be prescribed to treat migraine headaches as well as tension headaches, cluster headaches, post-traumatic headaches, and disease-related headaches that might be due to sinus problems, high blood pressure or sleeping disorders. The greatest advantage of acupuncture over Western medicine is that it does virtually no harm. Some medications can have serious side effects and can (in some instances) actually lead to patients experiencing a rebound headache. Unlike synthetic drugs, acupuncture has virtually no side effects, and the procedures for treating headaches are much less invasive with acupuncture than with surgery.
Headache (migraine), in Chinese medicine comes under the category of one sided headache and is characterized by recurrent attacks of headache, with or without warning signs or visual and gastrointestinal disturbances.
Chinese medicine aims not only to relieve the pain but also to deal with the root problem. Therefore, headaches are treated differently depending on their causes:
- Wind: Wind invasion can disturb the harmony of Qi (the body’s essential energy) and Blood causing headaches (e.g., as experienced during common cold)
- Excessive Liver Yang energy (i.e. hot energy): headaches are accompanied by dizziness, bitter taste in mouth, anxiety and short temperedness (e.g. in high blood pressure)
- Deficiency of Blood and Qi: slow onset of headaches accompanied by heaviness of head and eyes, tiredness or exhaustion and pale complexion
- Blood stagnation: headaches can be sharp and often have fixed locations; patients often complain of loss of memory and concentration, palpitations; some may have history of head injury.
According to Chinese Medicine theory, acupuncture, Chinese herbs and Chinese massage can be prescribed to treat migraines and headaches.
All the causes can be present in migraine and understandably treatment can be very different for each patient. People vary in their response to treatment, e.g. some respond better to acupuncture while others better to herbs.
Migraines – Chinese Medical View
Migraines are commonly experienced but can also be related to a person’s genetics. The condition tends to be up to 2-3 more common amongst women than men and is more likely to happen during the menstrual periods. Migraines tend to occur more frequently during hormonal changes taking place in the period when the human body is 15-20 years old. The incidence of hormone-related migraines decreases during pregnancy and after menopause.
Common triggers of migraine include stress, anxiety, overwork, insomnia, certain foods or medications and environment – including sunlight, damp weather or cold temperature. The main symptoms of migraine are pain in one side of the head, nausea, vomiting and sensitivity to light.
Chinese Medicine distinguishes between two basic causes of migraines: external and internal. To be more precise, a Chinese Medical doctor would not focus exclusively on treating the patient’s migraine, but on pinpointing the imbalance (technically known as ‘the syndrome’) where the cause of the migraine and other seemingly unrelated symptoms take root. Identifying the syndrome and restoring the balance will improve the patient’s overall health, with a relief in migraines being a natural outcome of the treatment along with other positive side effects.
In Chinese Medical terms, migraines of an external origin occur when Wind-Heat, Wind-Cold or Wind-Damp invade the the acupuncture channels located in the head. These are common syndromes, describing the process whereby environmental pathogens penetrate the body impede the movement of blood and Qi (together referred to as lifeblood) to the head.
Internal causes include genetics, improper diet, emotional problems or chronic conditions caused by functional disorders of the Liver, Spleen or Kidneys. For example, a deficiency in the lifeblood can lead to malnourishment of the sensitive acupuncture channels in the head which in turn causes migraine pain.
Another common syndrome recognised in Chinese Medicine as a root cause of migraine is a combination of internal Wind, build-up of phlegm and stagnation in the circulation of lifeblood which collectively cause blockages in the Shao Yang and Tai Yang acupuncture channels and lead to head pain.
Depending on the syndrome whereby the migraine has developed and the type of its cause (internal or external) identified by means of a detailed diagnosis, suitable Chinese herbs and acupuncture points are selected to treat the migraine at its root.
Chinese Medicine for Migraines related to Hormone Levels
Chinese Medicine combines herbal medicine and syndrome acupuncture to treat hormone-related migraines by subtly regulating the functional state of the Kidneys and the Liver – organs which both secrete hormones.
According to Chinese medical theory, Kidneys store the body’s essential energy (a matter which is vital for sexual activity and reproductive health) and control the production of bone marrow. The Yang (hot) energy utilised by the Kidneys to support the body, and which is carried throughout the organism by the bloodstream, is also important for the nourishment of the brain. A lack of supply in such energy to the head typically causes migraine pain.
In the case of Kidney Yang deficiency, Chinese Medicine is used to tonify the Kidneys – particularly in relation to the Yang arm of the organ’s operations – and ensure that the blood is circulating properly throughout the body so that the Yang energy is delivered to the head, brain is nourished and pain is alleviated through improved lifeblood circulation .
The Liver stores the blood (and therefore supports menstruation in women) and regulates the circulation of essential energy carried by the blood throughout the body. By using suitable Chinese herbs and stimulating the relevant acupuncture points Chinese Medicine can tonify the Kidneys, the Liver and subtly regulate their production of hormones – which in turn can treat the related migraine at its root cause.
Chinese Medicine for Migraines related to Stress and Anxiety
In Chinese Medicine migraines linked to stress, anxiety and worry are associated with the Liver and the Heart. According to Chinese Medical theory problems such as anxiety, insomnia or too much stress trigger migraines because they impede the Liver’s function of circulating lifeblood to the head, and, unsettle the Heart which is at the foundation of the person’s mental state.
Stress can cause Fire (a kind of heat) within the Liver and unsettle the balance between the organ’s cooling and warming properties, causing the latter (Yang, the opposite of Yin) to restlessly rise up the energy channel which links the Liver and the head and cause migraine pain. Insomnia and stress can also cause Fire within the Heart which can have a knock-on effect on the supply of lifeblood to the brain and lead to head pain.
To alleviate migraine pain caused by stress, anxiety and/or insomnia, Chinese Medicine uses a combination of acupuncture and specifix herbs to sooth the Liver and the Heart; clear out the Fire and control the rising Yang energy which, while relieving the patient’s stress and improving their sleep, can alleviate the related migraine pains. By treating the patient’s Liver and Heart with acupuncture and herbs, Chinese Medicine can strengthen the body’s ability to cope with pain triggers such as stress and anxiety and hence lower the incidence of migraines.
Migraines and Food – Treatment in Chinese Medicine
It is also important to mention that, since migraines of internal cause are linked to diet in cases where certain foods trigger the symptoms, Chinese Medicine has identified the Spleen as a key organ in the diagnosis and formulation of treatment. In Chinese Medical theory the Spleen performs a major role in the digestive system as the organ which processes the food and drink intake and assimilates the nutrients into the body.
Hence, Chinese Medicine states that in certain cases treatment of migraine must include regulating the functional state of the Spleen in order to improve the patient’s ability to digest and absorb the foods which trigger the migraine symptoms.
Lifestyle Advice for the prevention and treatment of Headaches
The next time you have a headache, try squeezing your little finger tip on both sides as hard as you can for several minutes. This stimulates the reflexology area associated with the head. The harder you press, the faster you will feel relief.
- Try a relaxation technique, like deep breathing, or Yoga.
- Drink things without caffeine in them: soft drinks, water, etc.
- Use ice packs. Ice can be very effective at the point of pain.
- Try to rest or sleep in a dark, quiet room.
Exercise – aerobic exercise, done for thirty minutes, five times a week, may help prevent headaches. It is probable that the endorphins released during exercise tend to promote a sense of well-being.
For personalised advice on diet and lifestyle, please ask the doctor during your consultation.
Please be reminded that we offer free online health advice.
+ *CLINICAL TRIALS
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Loh L et al. Acupuncture versus medical treatment for migraine and muscle tension headaches. Journal of Neurology, Neurosurgery and Psychiatry, 1984, 47:333-337.
Dowson DI et al. The effects of acupuncture versus placebo in the treatment of headache. Pain, 1985, 21:35-42.
Doerr-Proske H et al. [A muscle and vascular oriented relaxation program for the treatment of chronic migraine patients. A randomized clinical control groups study on the effectiveness of a biobehavioural treatment program]. Zeitschrift für Psychosomatische Medizin und Psychoanalyse, 1985, 31(3):247-266 [in German].
Vincent CA. A controlled trial of the treatment of migraine by acupuncture. Clinical Journal of Pain, 1989, 5:305-312.
Tavola T et al. Traditional Chinese acupuncture in the treatment of tension-type headache: a controlled study. Pain, 1992, 48:325-329.
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Weinschütz T et al. Zur neuroregulativen Wirkung der Akupunktur bei Kopfschmerzpatienten. [Neuroregulatory action of acupuncture in headache patients.] Deutsche Zeitschrift für Akunpunktur, 1994, 37(5):106-117 [in German].
Chen XS et al. [Observation of penetrating acupuncture treatment of migraine in 45 cases.] Shanxi Journal of Traditional Chinese Medicine, 1997, 13(6):32-33 [in Chinese].
Liu AS et al. [“Three Scalp Needles” in the treatment of migraine.] New Tradiitional Chinese Medicine, 1997, 29(4) 25-26 [in Chinese].
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