Here I will discuss dull headaches from the perspective of traditional Chinese Medicine (TCM). This kind of headache, is almost always due to an imbalance which creates an deficiency within the body. Nagging, tight, gnawing, sensation of emptiness and similar descriptions of the pain are an indication in TCM that the patients’ condition is deficient rather than a excess. There is too much of a particular substance, not too little. In contrast, excess headaches are described as throbbing, sharp and pounding.
I will review four common patterns of dull headaches and discuss and how they might be treated by a TCM practitioner. The TCM patterns I will discuss are:
Qi Deficient
Blood Deficient
Damp
Kidney Deficient
QI DEFICIENT – PATTERN
The most salient characteristics of dull headaches are that they encompass the whole head, come in bouts, are worse in the morning, better with rest and when laying down and worse with exertion. It of course is dull in nature. In addition, these patients complain of tiredness and some experience palpitations and others have loose stools.
Typically, these patients suffer from spleen deficiency, although there can also be a deficiency in other organ systems. The dull headache symptoms are the result of the Qi failing to ascend, and thus the brain is not properly nourished.
Treatment will involve developing a plan aimed at boost the Qi and aiding it in ascending. This could involve the selection of points such as Du 20, Sp6, Stomach 36, Ren 12 and similar points. In addition, if other organ systems are involved, then points to boost the Qi of those systems would be considered. Typically, that would include the source points of those channels.
Herbal treatments might include formula’s such as Si Jun Zi Tang, or in the case of palpitations, Qui Pi Tang. The herbal formula would be selected to boost spleen Qi and then modified to address other affected systems.
BLOOD DEFICIENT – PATTERN
These dull headache patients have pain that is reported as being slightly more intense than the Qi deficiency headache pain, although it is still dull in nature. In this case, the pain is located at the top of the head and is worse in the afternoon/evening. These patients report that their memory is poor and they find it difficult to concentrate. This pattern of headache is also improved by laying down. Woman report that they get this headache at the end of their menses, when they have less blood in their systems.
For these patients it is important to build blood. In addition to acupuncture and herbs, dietary changes may be in order. If the patient is a vegetarian, it will be important to attempt to bring meat back into their diets. Red meat is important to building blood and the lack of it in a diet will almost certainly result in blood deficiency.
A treatment plan will include points such as UB 17, 19 and 20. Spleen 6, Stomach 36 and Liv 3. In addition, heart points should be incorporated into a treatment given the heart’s role in building blood. Herbal formula’s such as Si Wu Tang should be incorporated and modification should be made depending on which other systems are effected.
DAMP – PATTERN
These dull headache patients report a sensation similar to a tight band around their heads with a sensation of heavy headedness. This headache is worse in the morning and often accompanied by digestive symptoms such as, nausea, a sensation of fullness and diminished appetite.
In addition there is often a fuzziness of the thought process, reported as unclear or foggy thinking and sinusitis. These symptoms are the result of the damp obstructing the flow of nourishment to the brain.
With these patients the goal will be to drain the damp and boost the spleen so that the damp does not recur. Points such as Spleen 6 and Ren 10 and 12 will be useful. In addition, points such as Stomach 36 and 40 and Spleen 9 should be considered. An herbal formula such as Shen Ling Bai Zhu Tang may be appropriate.
KIDNEY DEFICIENT – PATTERN
These dull headache patients describe the pain as being located inside the head. They describe a sense of emptiness of the brain and have an associated dizziness. This type of headache will often occur following sexual activity. Additional symptoms will depend on whether the patients condition is primarily yin or yang deficiency. For those who are yang deficient, additional symptoms will include cold extremity’s, decreased libido, increased urination, tiredness and a pale tongue with a thick wet coat. If the condition is primarily one of yin deficiency there will be low back and knee pain, night sweats, five center heat, dryness and a red coatless tongue. The yang form is less severe than the yin pattern.
These patients will need a treatment plan that focuses on building the kidneys and the primary focus on yin or yang depending on the pattern. Fir yin deficient patterns point such as Kidney 3 and 6, UB 23 and 52 and Ren 3 and 4 should be considered. The typical formulas for Yin Deficiency is Liu Wei Di Huang Tang. In the case of yang deficiency consideration should be given to Du 4, UB 23 and 52 and herbal formulas such as Jin Gui Shen Qi Wan or You Gui Wan.