37. Acupuncture and Intorable Headache

Jan 14, 2012   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments
News Letter, Vol. 4 (1),January , 2012, © Copyright
Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.
Robert Blizzard III, DPT
Rehabilitation Medicine and Acupuncture Center
1171 East Putnam Avenue, Building 1, 2nd Floor
Greenwich, CT 06878
Tel: (203) 637-7720
Fax: (203)637-2693

Intolerable Headaches




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Joan T., a sixteen-year-old schoolgirl, was brought to me by her mother because the girl had been experiencing headaches since she was twelve and first got her period. Her headaches were so severe that four or five days a week during her period she was often unable to go to school. These headaches manifested themselves on both temporal regions of her head and also caused severe pain to the left eye. Because of the pain’s severity, the headaches were interfering with her schoolwork. Joan had to call her mother several days a week to pick her up from school, which, for several years made it necessary for the mother to quit her job and begin to home school Joan.
At sixteen, Joan returned to school as a junior because she needed to start preparing for college entrance exams, as well as apply to colleges. Soon afterward, the pain had grown so severe that Joan was sleeping poorly and was extremely stressed, which often resulted in tears and depression, and, in turn, made her eat too much, causing a large weight gain. Her mother had taken her to many doctors over the years, and she had been prescribed a variety of drugs, but nothing seemed to help the migraines. Her SAT exams were coming up in two months when the mother finally brought her to me for evaluation.
A physical examination showed Joan to be a slightly obese young girl, very depressed, and stressed. She spoke in a low tone; did not like light, and felt pain when her temporal area and the back of her scalp, the occipital area, were touched.
Types of Headaches
I considered that Joan might have one of the following three types of primary headaches: tension, cluster, or migraine. She could also have a mix of two or three of them.
Tension Headaches
This is the most common type of chronic and frequent headaches. The symptoms include steady pain on both sides of the head with a feeling of pressure and tightness around the head, as if a band was put tightly around it. The pain radiates from the back, eyes, neck, or other parts of the body, and usually increases over period of hours. As it worsens, it can develop a pulsating quality.
Figure 1.1

Cluster Headaches
This type of headache is often described as a sharp penetrating or burning sensation in one eye where the person feels as if somebody had punched her or his eye. The pain comes on suddenly, without warning, and within a few minutes, excruciating pain develops that can be so severe some women report it is even worse than childbirth. People with cluster headaches often appear restless. These headaches usually last about two to twelve weeks, though some chronic cluster headaches may continue for more than a year. They sometimes go with seasonal change.
Figure 1.2
Migraine Headaches
A migraine headache is a throbbing or pulsating headache that is often on one side of the head and is associated with nausea and vomiting, sensitivity to light, sound, and smell, with sleep disruption and depression. These attacks are very often recurrent and do not change with age, sometimes developing into chronic migraine headaches.
There are two types of migraine headaches: migraine with aura and migraine without aura. Most auras are visual and are described as bright shining light around objects or at the edges of the field of vision, hallucinations, or zigzag lines with a wave image. Some people may experience dizziness, motor weakness, numbness, speech or language abnormalities, temporary vision loss, tingling, or vertigo.
Figure 1.3
An MRI of a Migraine
Causes of the Three Types of Headaches
  • The causes of tension headaches are usually stress, muscular tension, gouty arthritis on the neck or spine, postural changes, vascular dilation, protracted coughing or sneezing, fever and depression, or temporal mandibular joint disorder.
  • The cause of cluster headaches is unknown. However, cluster headaches are known to be triggered by alcohol, nitroglycerin, or similar drugs.
  • The cause of migraine headaches is also unknown. There may be a family history of the disorder, or a migraine can be triggered by many stimulants: alcohol, altitude, color, contrasting pattern, exertion, food, hormonal change, hunger, lack of sleep, medicine, perfume, stress, and weather.
Treatments in Western Medicine
From the Western medicine point of view, there are many different kinds of medications to treat headaches. For example, Topamax and Imitrex are used for migraine headaches with some successful result. However, when beta blockers, antiseizure medication, calcium channel blockers, tricyclic antidepressants, and analgesics, such as aspirin, ibuprofen, and acetaminophen, are used to treat migraine, cluster, or tension headaches, they cannot provide significant improvement for any of these headaches. Therefore, more and more people are starting to look for alternative treatments, and acupuncture is one of the best.
Treatments in Traditional Chinese Medicine
Chinese medicine classifies headaches in two categories.
External Wind Attack Headaches
These headaches are caused by external factors, such as wind cold and wind heat. The headaches are usually characterized by an acute onset and a very severe and constant attack.
  • Wind cold. This causes periodic attacks, where the pain always is connected with the neck and upper back and an aversion to wind and cold. The head feels heavy, as if a tight band is wrapped around it. The person does not feel thirsty, and has a thin, white coating on the tongue, and a floating pulse.
  • Wind heat. This type feels like a headache expanding from inside the head, accompanied by fever and an aversion to heat and wind, with a reddish face and eyes. The person feels thirsty, has constipation, yellowish urine, a red tongue body, with yellow coating on the tongue, and a floating pulse.
Internal Organ Dysfunction Headaches
These headaches are usually of slow onset with mild pain and sometimes the feeling of emptiness within the head. When people are stressed and overworked, the pain will be worse. The pain is on and off and usually lasts for a long time.
The Meridians
According to traditional Chinese medicine, the head, the face, and also the liver are where all six yang meridians go. Since these meridians go up to the top of the head, headaches can be diagnosed based on the meridian distribution. If you know the meridian distribution, it will be easier to make a clear diagnosis and treatment.
  • Tai Yang (Urinary Bladder) meridian headache. This is usually located at the top of the head, or the back of the head, and is connected to the neck.
  • Yang Ming (Large Intestine) meridian headache: This is usually in the front of the head—on the forehead—and includes the upper portion of the eye.
  • Shao Yang (Gallbladder) meridian headache: This is usually on both temporal areas and radiates to the ear.
  • Jue Ying (Liver) meridian headache: This is usually on the top of the head, sometimes connecting to the eyes and forehead.
Acupuncture for Headaches
I first ask my patient the location of the headache and its severity in order to find out which internal organ shows dysfunction. I next ask about the accompanying symptoms in order to differentiate the wind cold from the wind heat.
Figure 1.4
Figure 1.5
Figure 1.6
Figure 1.7
Figure 1.8
Figure 1.9
For Tai Yang (Urinary Bladder) meridian headache on the top of the head and back of the neck, the following are used: GB 20 Feng Chi, DU 16 Feng Fu, DU 19 Hou Ding, BL 9 Yu Zhen, BL 60 Kun Run, and SI 3 Hou Xi.
Table 1.1
Points Meridian

Number
Conditions Helped
1 Feng Chi Gallbladder 20

See Figure 1.7
Headaches, vertigo, insomnia, pain and stiffness of the neck, blurred vision, glaucoma, red and painful eyes, tinnitus, convulsion, epilepsy, infantile convulsions, common cold, nasal obstruction
2 Feng Fu DU 16

See Figure 1.7
Headaches, neck rigidity, blurred vision, nosebleed, sore throat, mental disorders
3 Hou Ding DU 19

See Figure 1.7
Headaches, vertigo, epilepsy
4 Yu Zhen Urinary Bladder 9

See Figure 1.7
Headaches, neck pain, dizziness, nasal obstruction
5 Kun Lun Urinary Bladder 60

See Figure 1.9
Headaches, blurred vision, neck rigidity, pain in the shoulder, back, and arm, swelling and heel pain, difficult labor, epilepsy
6 Hou Xi Small Intestine 3

See Figure 1.8
Pain and rigidity of the neck, tinnitus, deafness, sore throat, acute lumbar sprain, night sweat, fever, numbness of the finger and shoulder, elbow pain
Please refer to the accompanying Figures (illustrations) for the locations of
the points. And please note that these illustrations are for information only
and may not show all the exact locations of the acupuncture points.
The Yang Ming ((Large Intestine) meridian headache centers on the front of the head, the forehead, including the upper portion of the eye. The acupuncture points are Yin Tang and Tai Yang (Extraordinary Points), Lu 7 Lie Que, LI 4 He Gu, and GB 14 Yang Bai.
Table 1.2
Points Meridian Number Conditions Helped
1 Yin Tang Extraordinary Point

See Figure 1.4
Headaches, head heaviness, infantile convulsion, frontal headaches, insomnia
2 Tai Yang Extraordinary Point

See Figure 1.5
Headaches, eye diseases, off-center deviation of the eyes and mouth
3 Lie Que Lung 7

See Figure 12.2
Cough, pain in the chest, asthma, sore throat, spasmodic pain of the elbow and arm
4 He Gu Large Intestine 4

See Figure 12.3
Headaches, pain in the neck, redness, swelling, and pain of the eye, nosebleed, nasal obstruction, toothache, deafness, swelling of the face, sore throat, facial paralysis, abdominal pain, dysentery, constipation, delayed labor, pain, weakness, and motor impairment of the upper limbs
5 Yang Bai Gall Bladder 14

See Figure 1.4
Headaches, pain in the orbital ridge, eye pain, vertigo, twitching of the eyelids, tearing
Please refer to the accompanying Figures (illustrations) for the locations of
the points. And please note that these illustrations are for information only
and may not show all the exact locations of the acupuncture points.
The Shao Yang (Gallbladder) meridian headache is usually on the bilateral temporal area and radiates to the ear. The following points are chosen: GB 20 Feng Chi, Extraordinary Point 1 Tai Yang, SJ 5 Wai Guan, ST 8 Tao Wei, and GB 38 Yang Fu, and GB 39 Jue Gu.
Table 1.3
Points Meridian Number Conditions Helped
1 Feng Chi Gallbladder 20

See Figure 1.7
Headaches, vertigo, insomnia, neck pain and stiffness, blurred vision, glaucoma, pink and painful eyes, tinnitus, convulsions, epilepsy, infantile convulsion, febrile (fever) diseases, common cold, nasal obstruction, runny nose
2 Tai Yang Extraordinary Point

See Figure 1.5
Headaches, eye diseases, off-center deviation of the eyes and mouth
3 Wai Guan San Jiao 5

See Figure 1.8
Fever, headaches, cheek and neck pain, deafness, tinnitus, elbow and arm pain, hand tremor
4 Tou Wei Stomach 8

See Figure 1.10
Headaches, blurred vision, eye pain, excessive tears
5 Yang Fu Gallbladder 38

See Figure 1.9
Migraines
6 Jue Gu Gallbladder 39

See Figure 1.9
Apoplexy, neck pain muscular atrophy of the lower limbs, spastic pain of the leg
Please refer to the accompanying Figures (illustrations) for the locations
of the points. And please note that these illustrations are for information
only and may not show all the exact locations of the acupuncture points.
For Jue Ying (Liver) meridian headache, the pain is usually on the top of the head and it often connects to the eyes and forehead. The following points are chosen: Du 20 Bai Hui, Liv 3 Tai Chong, and Lung 7 Lie Que.
Table 1.4
Points Meridian Number Conditions Helped
1 Bai Hui Du 20

See Figure 1.6
Headaches, vertigo, tinnitus, nasal obstruction, coma, mental disorders, prolapse of the rectum and the uterus
2 Tai Chong Liv 3

See Figure 18.2
Headaches, dizziness, insomnia, congestion, swelling and pain of the eye, depression, infantile convulsions, uterine bleeding, hernia, retention of urine, epilepsy
3 Lie Que Lung 7

See Figure 12.2
Headaches, migraine, neck stiffness, cough, asthma, sore throat, facial paralysis, toothache, wrist pain and weakness
Please refer to the accompanying Figures (illustrations) for the locations
of the points. And please note that these illustrations are for information
only and may not show all the exact locations of the acupuncture points.
If the above symptoms are accompanied with the wind cold or wind heat signs, I add the following points:
For Wind Cold: GB 20 Feng Chi, Extraordinary Point Tai Yang, St 8 Tou Wei, GB 8 Shuai Gu, UB 12 Feng Meng, and UB 60 Kun Lun.
Table 1.5
Points Meridian Number Conditions Helped
1 Feng Chi Gallbladder 20

See Figure 1.7
Headaches, dizziness, insomnia, neck pain and stiffness, blurred vision, glaucoma, pink and painful eyes, tinnitus, convulsions, epilepsy, infantile convulsion, febrile (fever) diseases, common cold, nasal obstruction, runny nose
2 Tai Yang Extraordinary Point

See Figure 1.5
Headaches, eye diseases, off-center deviation of the eyes and mouth
3 Tou Wei Stomach 8

See Figure 1.10
Headaches, blurred vision, eye pain, excessive tears
4 Shuai Gu Gallbladder 8

See Figure 1.5
Migraines, vertigo, vomiting, infantile convulsions
5 Feng Meng Urinary Bladder 12

See Figure 1.11
Common cold, cough, fever and headaches, neck rigidity, back pain
6 Kun Lun Urinary Bladder 60

See Figure 1.9
Headaches, blurred vision, neck rigidity, pain in the shoulder, back, and arm, swelling and heel pain, difficult labor, epilepsy
Please refer to the accompanying Figures (illustrations) for the locations
of the points. And please note that these illustrations are for information
only and may not show all the exact locations of the acupuncture points.
For Wind Heat: GB 20 Feng Chi, Tai Yang, St 8 Tou Wei, GB 8 Shuai Gu, Du 14 Da Zhui, and SJ 5 Wai Guan.
Table 1.6
Points Meridian Number Conditions Helped
1 Feng Chi Gallbladder 20

See Figure 1.7
Headaches, vertigo, insomnia, neck pain and stiffness, blurred vision, glaucoma, pink and painful eyes, tinnitus, convulsions, epilepsy, infantile convulsion, febrile (fever) diseases, common cold, nasal obstruction, runny nose
2 Tai Yang Extraordinary Point

See Figure 1.5
Headaches, eye diseases, deviation of eyes and mouth
3 Tou Wei Stomach 8

See Figure 1.10
Headaches, blurred vision, eye pain, excessive tears
4 Shuai Gu Gallbladder 8

See Figure 1.5
Migraines, vertigo (dizziness), vomiting, infantile convulsions
5 Da Zhui Du 14

See Figure 1.7
Neck pain and rigidity, malaria, fever, epilepsy, cough, asthma, common cold, back pain and stiffness
6 Wai Guan San Jiao 5

See Figure 1.8
Febrile (fever) diseases, headaches, cheek pain, neck sprain, elbow, arm, and finger pain, hand tremors, abdominal pain
Please refer to the accompanying Figures (illustrations) for the locations
of the points. And please note that these illustrations are for information
only and may not show all the exact locations of the acupuncture points.
Joan’s Treatment
Joan’s headaches were very complicated. From the Western medicine point of view, her headaches belonged to the migraine category. However, her headaches were always triggered by nerve pain in the back of the head and worsened with her hormonal changes and menstruation. She had four to five attacks a week, and every time she had the nerve pain or a hormonal change, her headache symptoms would get worse.
After I made a clear diagnosis, I first used GB 20, DU 16, and Bai Hui, and then Tai Yang and LI 4. I gave Joan this treatment three times a week for about two months and also injected her with cortisone to block the left and right nerve pain in the back of her head. Her headaches improved a great deal after this treatment and she was able to take her SATs and apply for college. She was accepted by Boston College and when I followed up on her two years later, her mother reported that Joan had no more major headache attacks. She survived her college study and her mother is very thankful to me.
Acupressure Tips to Use at Home or Office
  • If you have a headache, be specific as to the site of the headache and identify if you have a Tai Yang, Yang Ming, Shao Yang, or Jue Ying headache.
  • After you identify the site of the headache, then try to locate the points by following the tables and illustrations above.
  • Acupressure the points with your knuckle, press with comfortable pressure on the points, count 20, and then change to another point. You should work any symmetric points at the same time.
  • Since the acupressure points are located mainly on your head, use the head points as the major acupressure points. You may ask your friends or family members to help you with moderate acupressure.

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