Research: Acupuncture for headaches and migraines
Western and Chinese medical perspectives on the energetic pathophysiology of cephalgia
Cephalgia, better known as headache, is one of the most common neurological symptoms in adults age 18-65. According to the World Health Organization, approximately 50% of people across the globe experience recurrent headaches, and 30% or more report experience with migraines. (1) The study of headaches and diseases of the head cover 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 Western medicine, there are three common types of headaches, which include tension headache, cluster headache, and sinus headache. (2) An additional headache type that is more common in the modern era is medication overuse headache. 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 in the head and upper neck, but it is helpful to understand the difference between them. As described, headaches often occur as a symptom of an underlying issue — not all headaches are migraines. Migraines are a neurological condition characterized by the presence of minor seizure-like activity in the brain. They are often experienced as a throbbing-type pain that manifests on one side of the head that can last from several hours to a few days. Due to the changes in brain activity that affects blood flow in 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 be genetic in some cases, 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 entire 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 type, as well as the level or stage of the primary disease that is 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 on 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, and or exposure to poor air quality. This can damage or obstruct the orifices in the upper body, leading to blockages which may be concurrent with opportunistic infectious agents (viral, bacterial, fungal or parasitic).
If a person is more active and energetic, has a tendency to experience anger or frustration, or who finds it challenging to manage their temper, they would generally considered to be a Yang-type of person. 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, taking in foods and substances that are harmful, or has poor health practices overall, this will lead to compromised resilience. If energy is blocked, or unable to circulate blood and other vital nutrients cannot nourish the mind, and a headache ensues. This also applies in cases where there is 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 headache 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 decreased number of days and intensity of pain with headache, along with improved quality of life. Another clinical trial conducted 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 there are extreme fires consuming acres of land leaving both human and non-human communities depleted. 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.