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Migraine and Tension Headache

Traditional Chinese Medicine for Headaches

Migraine headache is a common condition with a prevalence of 17.6% females and 5.7% males. It was estimated that 23 million people older than 12 years of age have severe migraine headaches. Medical research showed that there was a 60% increase in the disease from 1980 to 1989. The social and economic effects of migraine are staggering, between $2 million to $17.2 million are lost in productivity per year. A successful treatment plan for migraine headache has not only medical but also serious economic and social implications.

Migraine headache is a recurrent neurovascular headache disorder characterized by attacks of debilitating pain associated with photophobia, phonophobia, and nausea and vomiting. The highest incidence of migraine occurs between the ages of 20 and 35, and is often associated with a positive family history of the disease. Migraine headaches are classified into two diagnostic categories: migraine with and without aura. Migraine without aura (common migraine) consists of unilateral or generalized cephalgia, throbbing or pulsatile in nature, in conjunction with nausea, vomiting, and photophobia. Migraine with aura is preceded by a 15-20 minute episode of visual or sensory aura. Auras are most likely visual alterations, usually experienced as hemianopsia and scotomata that enlarge and spread peripherally.

Tension headaches are also common complaints, especially for women. Non-typical migraine and tension headaches are very similar and to distinguish from each other. From the holistic point of view, the causes for the headaches are similar and we always treat them the same way. High inflammation in the body is the baseline issue for both types of headaches. There are five common factors that cause inflammation and lead to headaches:

  • Allergy and immune response
  • Candida and intestinal toxins
  • Hormonal imbalance
  • Stress and emotional issues
  • Structural imbalance

Allergy related headaches could be a sinus problem. The pain is around your forehead and spread to one or both sides. It happens to individual with or without allergy symptoms. Allergy headaches are not easy to detect because of the delayed reaction from food allergies. If you have a headache in the morning, it may be related to the allergic food you ate last night. Sugar and wine are known to trigger headaches in the morning. Allergy testing such as electrodermal screening is useful to get clues what food and environmental factors bother you the most. With detoxification and Immune System Reprogramming, allergy headaches can be easily controlled. For those who have had allergy headaches for their whole life, the healing process may take a few years, but the headache may get better sooner than you think.

Candida is a hidden cause for many headaches. For more information about Candida please read Candida and Leaky Gut Syndrome. Candida overgrowth produces special toxins that may leak through a “leaky gut” to our body and cause a lot of physiological changes, such as hormone imbalance, problems in nerve and circulation systems, which in turn can cause headaches. Candida headaches normally come with sleeping disturbance, sugar craving and food indigestion. Solving Candida issue is not very easy. The therapy involves Immune System Reprogramming, detoxifying the body, helping ingestion and leaky gut. Special Candida protocol is used in the later stage of the IBMT including Candida control remedies and dietary changes. Without dietary changes the Candida problem will not go away easily and will come back from time to time.

Hormonal headaches often happen around ovulation or menstruation period. It happens a lot during menopause as well. The headaches often combine with other symptoms like irritable, mood changes, sleeping problems etc. Hormonal headaches are caused by high inflammation which is the result of hormonal fluctuation. Many factors cause hormonal fluctuation including immune response, Candida overgrowth and adrenal stresses. Chinese medicine is often used to treat hormonal headaches. Both acupuncture and Chinese herbs are effective to control hormone imbalance. Please read below for details.

Emotional headaches often happen to those who would like to hold their emotion inside. Emotions are processed through different meridians. If for some reason there is a blockage in the meridian, the specific emotion can not be released easily. Emotional blockage causes toxin build up, hormonal imbalance and adrenal stresses in the body. Adrenal stress caused by busy lifestyle also leads to headaches. Stress caused headaches are related to sensitive immune system, fluctuation of blood sugar and toxin accumulation. Solving emotional blockage and reducing stress is the key to help the headaches.

Structural headaches often happen after physical accident like auto accident, falling down or moving heavy object. Some patients don’t have clear accident but do shows structural imbalance such as spine misalignment. Structural headaches always start from the back of the head and often combine with neck or shoulder discomfort. A proper adjustment of bone or muscle with cranio-sacral and osteopathic technique will help to release the headache.

Clinically these above headaches are often mixed together. In the beginning we do not have to do specific therapy unless the type of the headache is very clear. The first thing we need to do is to reduce inflammation and detoxify because the direct reason to cause headache is inflammation. IBMT is very helpful to reduce inflammation in the body. Sometimes after initial chaotic layer is gone, the headaches are already getting better without even addressing specific root issue. But solving the root issue will prevent the headaches coming back forever.

Chinese medicine also works very well for headaches. Here I summarize some of the basics:


Traditional Chinese Medicine for Headaches

From the viewpoint of traditional Chinese medicine (TCM), migraine headaches are classified according to the overall condition of the patient, not only the nature of the headache. The headache is a result of disturbance or imbalance of Yin-Yang within the Zang-Fu organ system or the Channel system (Meridians), which are the two principal systems that regulate the functions of the body and mind. The diagnosis of TCM is the unique pattern differentiation of the clinical symptom-complexes, which represent specific pathological conditions that can be adjusted or reversed to physiological conditions by TCM therapeutic techniques such as medicinal herbs, acupuncture and Qi Gong therapy.

The disharmony of the Liver system is the most common reason causing migraine headache. According to the Zang-Fu theory, the Liver is the organ system that regulates the flow of Qi as well as stores the soul (related to mental activity). The smooth flow of Qi regulates emotional activities as well as ensures that the overall body activity operates normally. The disharmony of the Liver system, most commonly deficiency of Yin energy or excess of Yang energy, causes irregular Qi flow and Blood stasis, and accumulates Heat inside the body. Both the Qi stagnation and the Heat accumulation may result in migraine headache. The Liver type of migraine shows moderate to severe intensity, sometimes with pulsating quality and aggravation by walking stairs or physical exercise. This type of migraine is commonly in conjunction with emotional strain or stress, feeling of oppression in the chest and hypochondrium, depression or anxiety, reddened tongue with thin coating, and taut pulse.

Deficiency of the Kidneys is another common reason to cause migraine, especially for those patients with a long history of headache. According to the theory of the Five Elements (Phases), Water (Kidney) energy produces Wood (Liver) energy. The Kidney deficiency, caused by prolonged illness, may result in the Liver Yin deficiency and trigger headache. The Kidney deficient type of migraine shows mild to moderate intensity and is commonly in conjunction with weakness of lower back, low energy, lassitude, pale tongue, deep and weak pulse. Clinically there is a third type of migraine, which is the combination of the Liver type and the Kidney type of headache. The Liver Qi stagnation and Kidney deficiency may co-exist in the same patient.

Migraine headaches are also triggered by other pathogenic factors such as Wind, Damp Heat and Cold. Examining the nature of the headache usually helps to identify the factors causing the headache. For example, Wind causes a moving headache (the location of the pain changes); Damp results in a headache with heaviness; Cold causes a headache that may get worse when the temperature drops. In addition, the location of the headache also makes a difference. The forehead headache is usually related to Stomach meridian, the crown and back headache is related to Bladder meridian, while the side headache is usually related to the Liver or Gall Bladder meridian. However, the major pathophysiological change of the body is the Qi stagnation and Blood stasis. Pattern differentiation process recognizes the signature symptoms for each organ system as well as the pathogenic factors. Proper diagnosis should be made thorough analyzing the complete history of the patients and all presenting symptoms, followed by checking the tongue and taking pulse.

Acupuncture is the most common therapy for migraine. Efficacy of acupuncture towards migraine headache has been reported by many independent studies. Acupuncture analgesia has been thoroughly studied since the 70s. The major finding through these studies indicated that acupuncture stimulates endogenous morphine-like molecules such as endorphin and monoamine to block the pain signal. But acupuncture does far more than just the pain relief. It modulates endocrine and nervous system and stimulates self-healing process of the body. The actual mechanism is still unknown.

Acupuncture therapy uses very thin needles to stimulate acupuncture points on the skin. For migraine headache the following acupuncture points are commonly used: Hegu (LI 4), Tainchong (Lv 3), Zulinqi, and Fengchi. From my experience, a non-invasive electroacupuncture is also useful for this condition. Electroacupuncture is a method of stimulating acupuncture points with mild electric current. A number of points along the Stomach and Gall Bladder meridian on shoulder, neck and head, are often used. Electroacupuncture effectively relieves headache and relaxes tension of the muscle around the neck and shoulder. Chinese Tui Na (manipulation) for the neck and back also helps to relieve the headache. Dosage, duration and frequency of the therapy depend on individual patient. Most patients get some degree of relief after a single treatment. But the pain may come back after a few hours to a couple of days. This is due to the imbalance of the body. Multiple treatments are highly recommended because acupuncture analgesia has proven to be accumulative. Normally twice a week for 4-6 weeks (8-12 visits) is recommended. Complex cases with severe imbalance of the body may need longer time. For most of the cases, a properly prescribed Chinese herbal formula helps the patient to recover faster.

Chinese herbal medicine is another common therapy for migraine headache. Chinese herbal medicine has been used to balance the body with natural products for thousands of years. The theory behind Chinese herbs is the unique Yin-Yang and Zang-Fu theory, which is parallel to Western physiology. For the disharmony of the Liver system, the principle of treatment is to smooth the flow of Liver Qi and clear the Liver Heat. The prescription is based on specific symptoms of each patient as well as the experience of each practitioner. Decoction of Bupleurum chinensis (Chai Hu), Angelica sinensis (Dang Gui) and Paeonia lactiflora (Bai Shao) in combination with other herbs is commonly used. For the pattern of Kidney deficiency, the principle of treatment is to reinforce vital energy of the Kidney and Liver. The prescription is usually the decoction of Rehmannia gutinosa (Di Huang), Dioscorea opposita (Shan Yao) and Cornus officinalis (Shan Yu Rou) with modifications. Patent formula is also available for both cases. Chinese herbal medicine is the core of traditional Chinese therapies for migraine headache and is very powerful to balance the body. It significantly reduces the pain, shortens the headache attacking time, reduces the frequency of the migraine and prevents the headache from happening. The duration of Chinese herbal treatment is usually 1-2 months and also depends on individual patient's condition.

The tense lifestyle in the modern society is one of the reasons causing migraine headache and other related illness. The regularity of lifestyle, such as eating, resting and sleeping, is important for migraine patients in addition to the herbal and acupuncture treatment. Regular physical exercise, emotional control techniques and other calm activities are also necessary to prevent migraine attacking. Qi Gong is an ancient Chinese technique to actively promote circulation of Qi in the body and adjust the body inner clock to the natural clock. Similar to Yoga meditation, Qi Gong is the Chinese way to control and cultivate the energy of our body. It also serves as emotional control technique to prevent migraine headaches. Tai Ji Quan is another popular exercise in Chinese society. It combines Qi Gong and physical exercise and allows people to practice regularly to relax and adjust the conflict among the organ systems caused by the modern lifestyle. Both Qi Gong and Tai Ji Quan can be very good self-help techniques for migraine.

Diet is considered an important influence of health and illness in TCM. Food is believed to be part of the medicine and affects the result of the herbal treatment. According to Chinese theory, food is classified into different groups according to their nature and taste. Fatty and greasy foods, alcohol, coffee or sweets can produce Dampness and Heat, while spicy also produces Heat. Migraine patients should avoid those food items in their diet, especially for those patients diagnosed with the disharmony of the Liver. On the other hand, diet is believed to complement the nature of each human body. Properly designed diet plan according to Chinese theories will compensate Yin-Yang nature of the body and benefit the overall health in a long run. Consult a TCM practitioner for more information about the diet of each specific case.

For more information, please read Dr. Hong's official website and Dr. Hong's Blog.