Treating Throbbing Headaches With Acupuncture
Here I discuss throbbing headaches from the perspective of traditional Chinese Medicine (TCM). This kind of headache, is almost always due to an imbalance which creates an excess within the body. Throbbing, sharp, pounding and similar descriptions of bodily pain are an indication in TCM that the patients’ condition is excess rather than a deficient. There is too much of a particular substance, not too little.
I will review three common patterns of throbbing headaches and discuss and how they might be treated by a TCM practitioner. The TCM patterns I will discuss are:
Liver Yang Rising and its four sub-sets
Food Retention; and
Blood Stasis
LIVER YANG RISING – PATTERN
The Liver Yang Rising pattern has the symptoms of nausea and vomiting, dizziness, severe throbbing which occurs at the sides, temple, eyebrows or behind the eye. It is described as distending, pulsating pounding and bursting. The patient has visual disturbances, dry throat, tends to suffer from insomnia, has tinnitus or deafness, and reports feeling better when sitting up.
In addition, these patients tend to experience irritability and dizziness. Upon inquiry, it is almost always the case that the headache was preceded by an episode in which the patient experienced anger, frustration or resentment. The emotional association is a distinguishing feature of the Liver Yang Rising pattern of headache.
If a majority of these symptoms are present, the practitioner can safely make a diagnosis of Liver Yang Rising pattern of headache. However, that diagnosis alone is not sufficient for the practitioner to devise an effective treatment plan.
The Liver Yang Rising form of throbbing headache is somewhat unique. It never occurs without a concurrent deficiency condition. At this stage, the practitioner knows the general disease pattern. To devise an effective treatment plan, the practitioner must understand the underlying cause of the condition. The question which must be answered is — why is the Liver Yang is not properly anchored?
UNDERLYING CAUSES OF UNANCHORED LIVER YANG
At the stage in the diagnostic process, the practitioner knows that the onset of the headache is the occurrence of an emotional upset. The emotional upset causes the insufficiently anchored yang to rise to the head causing pain of the nature described by patients. The insufficiency of anchoring can have a number of causes.
There are four basic reasons that this might occur. The patient may have any of the following underlying conditions:
Liver Yin Deficiency
Liver Blood Deficiency
Liver-Kidney Yin Deficiency; and
Liver-Kidney yin and Kidney Yang Deficiency
The practitioner must make the additional diagnostic assessment as to which of these factors is the underlying cause of the Liver Yang Rising headache. The distinction between the various conditions will be seen in the tongue and pulse as well as the existence of additional symptoms typically associated with the underlying condition.
TONGUE PRESENTATION
The tongue will be 1) pale and thin in the case of liver blood deficiency;
2) dry and red, possibly peeled in the liver yin deficiency type;
3) red and peeled in the liver-kidney yin deficiency type; and
4) not generally of diagnostic value in the liver-kid yin yang deficiency type.
In the kidney yin/yang deficiency case, the tongue can present in a number of different ways depending on which of the underlying conditions is the predominant one. Other symptoms, such as mixed internal heat and cold conditions, low back and knee pain, and reduced libido will help to distinguish this as the underlying cause.
It is only at this level of diagnostics that the practitioner can make a determination as to the proper treatment approach. In all cases of liver yang rising the practitioner will select points to anchor the yang and to calm the shen. Other points will then be selected to address the specific sub-type of the pattern.
TREATMENT
In the case of the blood deficiency type of Liver Yang Rising throbbing headache, the focus of the treatment will be to tonify the blood. The practitioner would select points such as UB 17 and 19, Spleen 6, Ren 12 and Heart 7. An herbal formula to tonify the blood, such as Si Wu Tang might also be considered.
In the case of the Liver Yin deficiency variety of Liver Yang Rising throbbing headache, other points would be considered. These would include points to boost Liver Yin such as Liver 3 and 8. A formula such as Liu Wei Di Haung Tang might be prescribed.
Similarly, in the Liver-Kidney yin deficiency types, the liver yin points as discussed above would be included. In addition, points to boost the kidneys would also be selected. These might include Kidney 3 and 6, Ren 3, 4 and 5 and UB 23 and 52. A formula to boost the yin, such as Liu Wei Di Huang Tang.
For the Liver Kidney Yin Yang sub-type of throbbing headache, all of the points selected above will be useful and a combination herbal formula such as Ge Jie Du Bu Yin might be prescribed. The most significant thing to note is that there must be a fully explored diagnosis, as the treatment for each is often quite different and may in fact be contra-indicated in some cases.
Blood Stasis Pattern
DIAGNOSIS AND TREATMENT
The primary symptoms of this type of throbbing headache are severe intense stabbing pain always occurring in the same location and is extremely chronic in nature. It is often described as a nail being driven into the head. These patients will often have suffered a head trauma and their tongues will have a purple spot at the tip. Women often report having a painful clotted menses.
These patients will require herbal treatment. It will be important to use blood moving and breaking herbs for an effective outcome. Tong Qiao Huo Xue Tang is a classic formula for treating this pattern of throbbing headache.
Food Retention Pattern
DIAGNOSIS AND TREATMENT
This cause of this headache is obvious. It is aggravated by food intake, located at the forehead and described as being very intense. These patients exhibit digestive related symptoms such as burping, sour regurgitation, foul breath and a sensation of epigastric fullness. They tend to have thick sticky tongue coats.
Points to improve digestion would be the primary focus, such as Stomach 37, 25 and 28. Ren 10 and 12 and Spleen 6. In addition, a formula such as Bao He Wan might be prescribed to aid in eliminating the food stagnation.