Chapter 3.1: Migraine and other headaches

Migraine can be very devastating to the life of the sufferer. It is unpleasant for some but can be incapacitating for others. As we understand now, it is a consequence of vascular disorder. More precisely, it is the expansion of arterioles on the side of the head. As such, events which causes alteration of blood flows to the head could affect the migraine episode. Among them is the menstrual events which tend to cause the emotional fluctuation, loss of blood and the body’s response to all these events. It is no wonder female migraine sufferer outnumbers male by a large number.

Pathologically, as capillaries expand on the temporal area of the head, they pressurize the adjacent nerve receptors and hence trigger the headache. The root cause is that the tissues in these area demand more blood flow. Unfortunately, as with other bodily event, the pain actually triggers musculature of the area. It triggers the head and the neck to tense up which further reduce the blood flow into the head.

Therefore, our modern medicine of treating the migraine has been to constrict the arterioles to reduce the pressure to the nerve. It works in reducing pain for as long as the medicine remains potent. On the other hand, the true culprit, the demand of more blood flow is not been resolved setting up for the next episode of migraine.

3.1.1 A 55 year old female, artist complained having severe headache for over 20 years. It happened every day. She had not had a restful night all these years. It showed on her face and work, excessive aging. She also complained about tight neck muscle and some low back issues, she attributed that to the moving her big art works.

She also had the hot flush disturbing sleeping at night for two years. She couldn’t take medicine because that would trigger her asthma attack.

Naturally, her neck and upper trap were tight to touch. It felt like pressing on wood board. It turned out that she was attacked once by an intruder. She was choked from behind and that she was so certain that she would die. Years past, she still remembered the incident vividly.

I treated her with the above protocols for neck and shoulder. Within a few weeks, the headache was reduced to twice a week. A few months later, the headache had stopped all together. The tightness of neck/shoulder muscle had improved, although not totally disappeared, as unconscious reminder of the attack. The headache never return when checked one year later.

3.1.2 A male patient of 62 years old auto mechanic had debilitating headache, continuously throughout the day and night. This happened after surgery to fuse cervical spine. Before the surgery, he had chronic neck pain due to “wear and tear”. He worked as auto mechanic.

Surgery scar was about 3 inches long, visible at the front right side of neck above the collar bone. The surgery did not resolve his problem. Instead, ever since the surgery; he had headache, neck pain, chest tightness, arm pain. He couldn’t raise left arm for more than 45 degree without excruciating pain going down from deltoid to anterior aspect of his arm. His left arm pain was worse than the right. He was taking Celebrex. The senses of the left fingers were diminishing due to what his doctor diagnosed as atrophic nerve from diabetes. For which the doctor prescribed Neurontin (This is kind of odd prescription, as Neurontin diminishes nerve activity to suppress pain sensation.).

Acupuncture brought him a lot of relieve. Following the same procedure of releasing the neck shoulder and occipital explained above. Unfortunately, the worker’s comp was very biased against acupuncture. He had very hard time to get continued acupuncture. Overall, he was able to get 12 visits over two year’s time. That was considered as lucky. He still had headache although at a much less intense level. It would gradually become worse and needed be treated pay from own pocket. He is still trying to get the insurance company to authorize more acupuncture.

More on Headache

Headache is a very common problem. It is annoying at the least. In serious situation, it is quite debilitating, as is frequently the case with migraine sufferers. The presenting symptoms vary a lot: heaviness of head, foggy head, pins and needles, knifing sensations, pressure, and vise gripping at the side of the head.

The most important issue in treating headache is accuracy of diagnosis. It dictates the effectiveness. Because the head is always exposed to the outside world, it is subjected to the impact of environmental factors. For instance, without proper head protection in the extreme cold, head would be hurting. When sinus problem is triggered by the weather and acts up, headache ensures. Situations like these are easy to diagnose and easier to resolve. When headache persist, people become dreadful of brain tumor. Fortunately, that instance is rare and can easily rule out by modern imaging technique. In addition, the pain is usually unrelenting that does not vary much throughout day and night. There are also likely to have other unusual neurological events as well, such as pain or strange sensation in other parts of body that is difficult to diagnose. On the other hand, most brain tumors do not cause headache.

A 30-year old female employed at a cosmetic company had a strange complaint. For many years, she had this headache which was located deep behind her left eye. The pain usually got worse in the afternoon. Medication was not able to help her relieve the problem. Other than the pain, she appeared healthy and energetic.

Upon questioning, she recalled an accident she had as a child where she sustained a head injury that required suturing of the scalp about two inches above the lateral edge of the left eyebrow. The doctor had assured her that the injury had completely healed. Hidden under the hair, the scar could be felt from the suturing.

The best way of removing blood stasis at the body surface is using moxibustion together with electro-acupuncture. After three visits, her headache disappeared.

Head injury can cause headache in the later years. In 1999, I had this beautiful female patient in her 30s came in for acupuncture. She came with a small baby in baby carriage. She did modeling in Europe before moving to the United States. Everything was great for her except she had this bad headache that just would not go away for many years. No medical doctor could find anything that leads to her condition. No medical treatment was able to solve it.

It turned out that on her head there was a quarter size spot that was painful to pressure.

This is indeed an interesting case. In TCM, it is well known that in numerous situations, pain is caused by blood stagnation. Such stagnation can be resolved by bleeding. This is accomplished by acupuncture needles or a special needle that has three edged tip. Mostly, only a small drop of blood is let out. In a severe situation, it is coupled with a procedure called cupping where a suction cup was applied to the needled spot to facilitate the bleeding of the stagnated blood. This is rarely done in U.S. as we are very sensitive about blood spill in this country.

Bleeding is not uniquely TCM. It was the main stay of medical treatment in Western world such as France and America in the 17^th century. In that good old times, whenever people had a fever or distention of the head( possibly high blood pressure), they would go to their favorite barber shop and had some blood drained. Barbers at the time was competing with surgeons for business and winning. George Washington, founding father of U.S.A. had a fever and was treated by bleeding. Unfortunately, he died the day after the treatment.

Instead of doing blood letting, I did moxibustion on her head for a few minutes. The pain subsided and the headache was gone.

As with the diversity of symptoms for headache, there is diversity of causes. The list includes stress from physical and emotional, traumatic injury, vascular excess or deficiency. Since pain sensation is a neurological event, it is no surprise that nerves are always involved, so is the mind/ emotion of the patients. As long as the source of the problem remains unresolved, pain will continue.

SO, it is important to know the history or progress of the disease. For instance, if the person has neck and shoulder pain first and then the headache started to show up, then it is most likely the headache is the consequence of neck problem. The first line of treatment is to resolve the neck issue with minor focus of symptomatic treatment of the headache. Neglect the neck problem, the headache will never disappear

Headache with high blood pressure

High blood pressure would cause headache. In TCM, this is called Liver Yang rising. With severe cases, Yang rising can trigger Liver Wind and patient will experience dizziness. It could result in Wind Stroke and the person becomes unconscious. In modern terms, this is called stroke due to bleeding in the brain. As we age, our capillaries become stiff, less elastic and break easier under high pressure.

A family friend is a Philippine lady in her early 60s. With stressed life and rich Philippine food, she developed high blood pressure. Naturally, she is on med. The headache would frequently occur and it would be so debilitating. Following the acupuncture protocol above for the neck and shoulder, adding Lv 3 for liver and Tai Yang for temporal tension, her headache would subside. Life would then be better for a while.

A strange case of headache

A female student in her late 40s had this weird headache for as long as she can remember. The pain is located at the top of the head, about 2 inches radius. She always had hot sensation at this area. She could not recall how it could have happened. She also had the problem of eyes that became blurry walking into a closed space.

I did indirect moxibustion on her head for about 5 minutes. She felt warm and comfortable with heating. She felt the pain was reduced somewhat. However, after overnight, she started to feel uncomfortable at the whole head. That discomfort lasted for five days, and then in the morning, her eyes started twitching. After the dinner, her right eye felt tension. At about 10:30pm her son asked her what happened to her right eye as the lateral half of her right eye appeared blood shot. All she can recall was that she felt something pop inside the skin at the temporal area before this happened.

The funny thing is that her 40 some year’s headache had disappeared. Strangely, the “heat” sensation at the top of the head was also disappeared.

The red eye was caused by internal capillary bleeding in the right eye. Certain capillary inside temporal area supplying for her right eye was leaking. She went to family doctor and was told that indeed there was capillary leakage and it was not serious although it looked awful.

Apparently, this lady had a long standing blood stagnation issue that caused for her lifelong headache. As is frequently the case, the blood stagnation turned to heat as body tried to resolve the problem (modern language: inflammation, which caused headache). With the moxibustion, the body was able to revive the stagnated blood and found an outlet and resolved the issue. Since I did not do bleeding, her body found its outlet which lead to the right eye.

I saw her the day after the red eye happened; I applied indirect moxa around her eyes (never moxa over the eyes) and told her to do it at home. She also had fellow students did acupuncture work around GB 1. In a week, most of the redness has disappeared. The headache never comes back.

By week three, the redness in the eye was almost gone but now her complaint was about tension around the right eye. The tension was made better with indirect moxa, needling at UB 1 and Tai Yang. Later on, I found that she had LASIX surgery to correct her vision which had been causing her tension around the right eye and perpetual dry eyes. So the tension around her eyes might not be related to the treating of her headache.

Chapter 2.2: Neck & Shoulder – Auto accident, work-related injury, and cervical disc herniation

In an auto accident, people most commonly suffer the whip lash. Their heads are thrashed forward and suddenly pulled backward like the tip of a whip during whipping. In many accidents, more than whip lash injury can happen. Strained torso, impacted chest, twisted low back do happen. Sometimes, the head inside the skull can be injured physically as well.

Head trauma is very serious. Peculiar thing happens after some accident. Often the victims may have been shaken up violently during the accident, but are not aware of much pain. They would be rushed to the hospital, underwent a battery of exam including x-ray, MRI They are pronounced as healthy and quickly released from the hospital with clean bill of health. This is totally inappropriate diagnosis but happen all the time.

The diagnosis is based on the status of victims in shock. There is a disconnection between the mind and the body under such situation. After a while, the sign of injury starts to show up, pain also starts to increase and gets more and more severe with time.

In any case, some victims probably would go through a month or two of physical therapy and then will be taken off the insurance company’s list. Some do recover nicely, many do not. Many people would feel certain improvement but not completely pain free. Furthermore, lingering pain continued, frequently intensified much later. It becomes difficult to relate to the accident. This is not a good thing from legal perspective.

For this reason, I routinely inquire about the history of auto accident when a new patient comes in. I would also ask history of any other traumatic events. Not surprisingly, very frequently, way too many patients would have been involved in auto accidents. Some even have multiple auto accidents. The accidents could be just a few weeks earlier. For many, incidents actually happened long time ago, like years.

Auto accident is sad consequence of our modern society. For some people, lives are changed forever with perpetual health issues. For some of these people, they are not aware of their health issues were related to earlier auto accidents.

For a simple rear ended collision, the neck could be shaken quickly, violently. The cervical spine suffered front and back jerking. So, the treatment is to resolve the injury sustained from that. Frequently, the N-S acupuncture protocols works quite well and would be quite sufficient. For a more severe situation, several additional acupuncture points may be needed as well.

Note: Ask the patient to flex the neck. there should be no tension at all. Otherwise needle Cheng Jiang, Ren 24. This is using Ren Meridian to treat Du meridain.

These points include Bai Hui, or Du 20. This point belongs to Du meridian and addresses the spine disorder. The Ren 24, Cheng Jiang for cervical spine which is on the Ren meridian, used because of Yin and Yang coupling relationship. It released the pain and stiffness at the T-1 of spine. Frequently, SI 3, Hou Xi is needed because they are the Lou point of Du meridian. It addresses the pain along the spine. If the pain is at the occipital, then UB 65(Shu Gu) has to be needled, on the same side as pain. This point can be used for lots of other problems but is a sensitive spot that I don’t like to use it unless necessary.

Evaluate the progress after needling each point. I like to ask the patient to turn the neck from side to side to see the progress. It was found that the therapeutic result gets a boost if the patients exercise the painful area while needles are in.

The result should be quite impressive, regardless of the duration of the injury. In addition to moving the stagnated Qi, I suspect that is also because of resetting of neurological memory( so called muscle memory).

As mentioned above, the mode of automobile injury can be complex. Therefore, if the above N-S treatment method only brings about some degree of pain relieve. It would suggest that other parts of body are significantly injured as well. Two likely scenarios are the twisted torso during the collision or pulled chest muscle caused by restraining safety belt. Under these circumstances, certain areas on the chest near the shoulder joint, under the clavicles, the flank of the body can be sore to the touch. Needle painful area, or better yet, apply indirect moxibustion over the painful spots generously. The pain in the neck would show relieve immediately.

A female patient had a complaint of tight shoulder. Sometimes it would be so tight that it became painful and head would hurt. I asked her to turn head from side to side. It was apparent that her right shoulder was very tight. The right upper trapezius muscle was tender to the palpating pressure. Bending the neck caused the achiness at the occipital area.

I inserted needles at the regular places- Luo Zhen, SJ10. The improvement was moderate. I then added SI 3, Ren 24, Cheng Jiang and Tiao Kou, St 38 on the right. The pain was further reduced but still not completely gone. This implied that it was a more complex case with multiple sources of problems. I palpated her left infra clavicle area. Both distal and proximal ends of sub clavicle exhibited sensitive to palpation. I used indirect moxibustion on these areas until she felt too hot. Immediately, the tightness of the shoulder disappeared. Her comment was that she never aware that the left chest is so sensitive to touch.

A 62 year old female patient who was injured in an auto accident. Front and rear of the car on the driver side were smashed. The car was totaled by the insurance company. The above mentioned treatment was successful. However, in addition to the pain mentioned above, a few weeks after the accidents, her right head started to hurt so was her left eye. She felt constant pressure on the left eye. She was examined and referred to glaucoma specialist. She was told to be a good candidate for laser treatment of glaucoma. This was strange as glaucoma usually takes a while to develop. I used indirect moxibustion over her forehead, her left temporal area and area up to one inch inside the hairline on the left side. After three sessions, the eye pressure disappeared, so was the headache. A couple follow-up treatments and the problem seemed gone. She continued for treatment for about three months for other injury.

Moxibustion on and over the head /face needed to be conducted with extreme care. Historically, acupuncturists try to stay away from such practice as much as possible. However, I found it is very powerful and useful. I achieved lots good results that are hard to get with other modality. But, great care has to be exercised to prevent patients from burn injury due to the debris of moxibustion stick. Do protect all the eyes thoroughly. Otherwise, don’t do it.

Cervical disc herniation

Herniated disc syndrome refers to the protruded disc from the spinal column. It can happen in the cervical area between C-5 to C-7, cervical spine or the low back between L3-L5, lumbar spine. These areas have unprotected spine and are subjected to majority of motion. Other places also could have it but much rare.

A 40 year old female was struck accidentally to the neck by an object while at work. She was referred to me by a chiropractor friend and an MD when the pain at the neck had spread to the left cheek.

X-ray has shown that her cervical area suffered from a herniated disc injury, “up to 2 mm broad based posterior disc protrusion at the C5-C6” and “up to 5 mm left posterior-central disc protrusion severely compressing the adjacent sac and moderately compressing the left margin of the spinal cord which is displaced posteriorly at the C6-C7 .” according to the radiology report. Her neck’s range of motion from side to side is only about 45 degree.

The acupuncture treatment was performed followed N-S protocol, plus a few additional points. The pain immediately reduced. After 12 weekly visits, she had a complete range of motion, no pain at the neck or facial area. Interestingly, x-ray continues to show some disc herniation at the C6-C7. Years later, the patient still showed no problem on the neck.

What is meant by “Cure” of herniation of discs?

Such incident brought about a question about concept of “ cure”. The fact about herniated disc problem is that the presence of herniation does not necessary causes significant health problem. People can have herniated disc yet walking around without any discomfort. Clearly, herniation of disc does create potential physical interference to the nerve. The good posture would therefore be preferred for the optimum health. More important, with good posture, the reversal of herniation is possible.

Be the first to know about my new coming book! Join our exclusive list for updates, sneak peeks, and special launch offers. Don’t miss your opportunity to elevate your practice and deepen your knowledge.

👉 Sign up now and stay connected!