Before talking about migraines, it is important to differentiate between a headache and a migraine headache. In terms of headaches, there are three basic types: tension headaches, cluster headaches, and sinus headaches. All of these headaches are associated with discomfort, pain and/or pressure in the head with pain levels usually categorized as mild to moderate. The difference between a headache and a migraine headache is that migraines, in addition to having the same signs and symptoms as a headache, will also include:
- nausea
- dizziness or vertigo
- seeing spots or flashing lights
- sensitivity to light, sound and/or odors
- temporary vision loss
- tunnel vision and/or blurry vision
- auras
- vomiting
- cold sweats
Migraine symptoms typically last 4 to 72 hours and may be severe. Pain is often unilateral and throbbing, and worsens with exertion. For some migraine sufferers, there may be relief with a change of physical position, but for some there is no relief no matter if they sit, stand, or curl up in the fetal position. Migraines affect 18 percent of women and 6 percent of men. They most commonly begin during puberty or young adulthood, but change in frequency and severity over the ensuing years. Migraines most often diminish in both women and men by the age of 50.
Upon diagnosis by a MD—usually by a neurologist—migraines can be treated by a variety of Western pharmaceuticals. MD treatment includes triptans, dihydroergotamine, antiemetics, and analgesics, which are taken with the onset of a migraine. Preventive Western medicine regimens include lifestyle modifications, such as changing sleeping habits or diet, and certain drugs that are taken everyday, such as β-blockers, amitriptyline, topiramate, and divalproex. The downside of a lot of these medications is the side effects. In addition to drug toxicity and possible drug and/or alcohol interactions, as well as food interactions (grapefruit is most commonly contraindicated), these drugs can also cause extreme fatigue, inability to operate machinery or drive a car, nausea, rebound headaches, and in some cases, cold limbs.
There have now been many controlled trials of acupuncture for the treatment of migraine headaches. The trial results are consistent in proving that acupuncture for the treatment of migraines is significantly better than no treatment for managing migraines and in addition, acupuncture appears to be at least as effective as prophylactic drug therapy—only without the contraindications or unpleasant side effects.
Acupuncture can help in the treatment of migraine by:
- Providing pain relief. By stimulating nerves located in muscles and other tissues, acupuncture leads to release of endorphins and other neurohumoral factors and changes the processing of pain in the brain and spinal cord (Zhao 2008, Zijlstra 2003, Pomeranz, 1987).
- Reducing inflammation. By promoting release of vascular and immunomodulatory factors (Kim 2008, Kavoussi 2007, Zijlstra 2003).
- Reducing the degree of cortical spreading depression (an electrical wave in the brain associated with migraine) and plasma levels of calcitonin gene-related peptide and substance P (both implicated in the pathophysiology of migraine) (Shi 2010).
- Modulating extracranial and intracranial blood flow (Park 2009).
- Affecting serotonin (5-hydroxytryptamine) levels in the brain (Zhong 2007). Serotonin may be linked to the initiation of migraines, and 5-HT agonists (triptans) are used against acute attacks.
Location of the migraine can help the acupuncturist determine which channels are affected:
| neck | tai yang,
wind-cold invasion or Kidney deficiency |
| forehead | yang ming,
Stomach heat or blood deficiency |
| temporal | shao yang,
wind-cold or wind-heat, or Liver / Gallbladder fire rising |
| vertex | jue yin,
Liver blood deficiency |
| whole head | wind-cold |
And signs and symptoms of migraines can help to determine which type of Traditional Chinese Medicine (TCM) pattern is presenting:
| stagnation of LV qi | – distending / pulsating pain (one-sided)
– emotional depression – chest tightness, belching |
| hyperactivity of LV yang | – distending pain in head
– dizziness, blurred vision, tinnitus – anger, irritability, insomnia – flushed face, red eyes |
| blood stasis obstructing collaterals | – persistent and steady headaches
– pricking / pulsating pain – forgetfulness and palpitations |
| retention of coldness and static fluid | – headaches with brain fog and heaviness in both the head and body
– tight band sensation around head – distention of chest and/or abdomen – nausea / vomiting, stomach upset, cold limbs, no appetite, fatigue |
Once the acupuncturist has determined a TCM diagnosis for the patient’s presentation of migraine headache, a treatment plan can be made. The acupuncturist will use acupuncture and, in most cases, use the patient’s unique TCM diagnosis to make patient-specific dietary and lifestyle suggestions. Cupping, Gua Sha, and/or Tui Na (a style of TCM massage) may also be added to the treatment plan.
Whereas a Western medicine approach to the treatment of migraines uses a universal treatment method wherein most patients take one kind of medicine for similar types of migraines, acupuncture treatments are uniquely formulated for each individual person. Acupuncture and TCM use a holistic approach to strengthening and balancing the individual’s constitution as well as targeting the signs and symptoms of a migraine.
What is most beneficial in using acupuncture in the treatment of migraines is it takes a preventative approach without side-effects. Over time, with continuous acupuncture treatment, most patients tend to have fewer and fewer migraines. Therefore, acupuncture is able to not only treat the signs and symptoms of a migraine headache and relieve pain presentation, but it can treat the root cause of the migraine and prevent the recurrence of migraine pain in the individual over time.
Dr. Sarah Emily Sajdak, DAOM is a licensed acupuncturist specializing in the treatment of headaches and migraine headaches in the Greenwich Village area of New York City. To book an appointment with Dr. Sajdak, please visit her website and use the “book now” button to schedule online. Insurance is accepted and can be submitted through the secure website.
by Dr. Sarah Emily Sajdak, DAOM, L.Ac
Owner and Licensed Acupuncturist at Aquarius Acupuncture, PLLC
www.aquariusacupuncture.com
References:
Armm, Brendan (2007, September). Oriental Medicine and Migraines. http://www.acupuncturetoday.com/mpacms/at/article.php?id=31573
British Acupuncture Council. (2015, February 4). Migraines. https://acupuncture.org.uk/fact-sheets/headache/
Maciocia, Giovanni; The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Second Edition 2nd Edition, Churchill Livingstone; 2 edition, July 27, 2005.
http://www.merckmanuals.com/professional/neurologic-disorders/headache/migraine
Nall, Rachel. (2015, September 8). Migraine vs. Headache: How to Tell Them Apart. http://www.healthline.com/health/migraine/migraine-vs-headache#Migraines3
http://www.shen-nong.com/eng/exam/headaches_chinese_medicine_understands.html
http://www.webmd.com/migraines-headaches/news/20120112/acupuncture-may-be-effective-for-migraines