Get to the root of headaches and migraines
How does biomedicine and Chinese medicine view the root cause of headaches and migraines?
Defining headaches and migraines
Cephalgia, better known as a 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. The study of headaches and diseases of the head covers a wide range of ailments and requires a cross-disciplinary approach to care. 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 living longer with declining health, and young people experiencing impediments to wellness, more research will help to understand these intersecting factors.
In biomedicine, the three common types of cephalgia are tension headaches, cluster headaches, and sinus headaches. Additionally, medication overuse headache is a headache type that is now more common in modern diagnostic medicine. In each type, there is typically the presence of persistent and recurrent pain in the head, which is expressed most intensely 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.
Both headaches and migraines describe pain present in the head and upper neck, but it is helpful to understand the difference between them. Headaches can occur as a symptom of an underlying issue, and not all headaches are migraines. Migraines are a neurological condition characterized by minor seizure-like activity in the brain. The most common sensation is 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, a range of other symptoms are involved, including nausea, vomiting, light/sound/smell sensitivity, visual disturbances (auras or flashes), dizziness, and fatigue. 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 symbolizes the sky or heaven, as it is the highest area of the human body. Anatomically, the head is also a place where many blood vessels and collaterals meet. The natural flow of blood and energy moves upward—like sap rising from the roots of a tree to the branches—and can leave this area of the body (including the head, neck, and face) quite vulnerable to external climatic factors. 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.
Causes of headaches and migraines
Headaches and migraines can develop due to a host of factors, some of which are congenital. The list is not extensive but includes several causes from a biomedical and Chinese medicine perspective.
A pathogenic wind can invade the upper part of the body. Pathogenic wind (a pathogen carried through the air) can combine with different temperatures, including cold, summer heat, heat, dryness, and dampness. The invasion of wind is often due to sudden or unusual changes in the weather or exposure to poor air quality, damaging or obstructing the orifices in the upper body and leading to blockages that may be concurrent with other opportunistic infectious agents (viral, bacterial, fungal, or parasitic).
If a person is more hyperactive, is quick to experience anger and frustration, or cannot regulate their temper, they have an excess-type constitution. They may also experience frequent spikes in emotional or physiological reactivity, causing injury to bodily energy via stagnation. This person may also be prone to conditions that damage the body’s vital fluids and nutrients and impede the delivery of neurotransmitters, such as dopamine and serotonin, which help to 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. A person’s internal energy may be blocked or low, leading to decreased circulation. In this case, headaches can also develop as a result of depressed or suppressed emotions. It can also occur along with a chronic disease or a congenital deficiency.
In some cases, a congenital condition known as Chiari malformations can lead to severe migraines. This condition causes structural issues in the brain and skull during fetal development. It can also occur with changes in spinal fluid due to an injury, disease, or infection. Chiari malformations occur when the lower part of the brain extends through the base of the skull and cerebellum, putting pressure on the spinal canal.
Other common causes of headaches and migraines:
Anxiety
Insomnia
Dehydration
Muscular injury
Nutritional deficiencies
Environmental or food allergies
At-home care strategies
There are several ways to stave off a headache or decrease migraine-related pain before it worsens. Breathwork is a powerful tool to practice at the onset of a headache or migraine and as a preventative measure. The American Migraine Foundation cites that relaxation therapies, such as paced breathing and mindful meditation, can prevent migraine attacks. Keeping the body covered—especially the neck and head—is important in maintaining a healthy immune system. Wearing a scarf when it is windy, chilly, or cold, and not going to bed or outside with wet hair can add another layer of protection. It is also essential to ensure proper hydration and nutrition. Sometimes, a headache or migraine can occur when electrolyte levels are low or if the body is lacking enough nutrition. Tracking macronutrient consumption (carbohydrate, fat, protein) and micronutrient intake (vitamins and minerals) benefits overall health and helps maintain homeostasis.
Acupuncture and Chinese medicine for headaches and migraines
Evidence-based research shows promising results for headaches and migraines. A clinical trial on acupuncture in patients with headaches shows that people who receive acupuncture in combination with routine care are associated with marked clinical improvements compared to those who did not receive acupuncture. 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.
A note on ecological entwinement
The rise in headache-related issues is, in many ways, symbolic of what is happening within nature. Across the globe, the world’s winds are speeding up amidst long-term global warming while extreme fires consume large swaths of land. Human and non-human communities are vulnerable to being displaced from their homes, further compromising ecologically stable environments. Humans easily forget that we, too, are a part of nature, and our bodies are unique ecosystems. Through a functional—dare I say, ecological—approach, relaxation therapies including breathing meditation, acupuncture, and Chinese medicine can be a helpful ally to those who experience headaches and migraines, no matter the root cause.
Want to explore breathwork?
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.