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Issue #4: Headaches

Dear Friend,
            
        We had our second seminar about the introduction of TCM on Wednesday, May 29th, which was another success. If you missed the seminars, but are interested in learning more about the basics of TCM, feel free to come in to our clinic to ask about TCM.

        If you haven't already done so, check out our Facebook page (Toronto School of Traditional Chinese Medicine) and our Twitter account (@TSTCM_clinic).

 
Sincerely,
Dr. Mary Wu
Toronto School of Traditional Chinese Medicine


 

TCM Treatment of Headaches

By: Katherine Chekhter (Specialized Honors B.A. (Psychology), R.Ac.)

 

Headache

Introduction

     School is finally out, and the children cannot wait for the summer vacation to start. However, not all parents feel the same. For them, it is the beginning of headache season. According to MediLexicon's medical dictionary, Headache means "Pain in various parts of the head, not confined to the area of distribution of any nerve". In fact, there are several different types of headaches and they rank among the most common pain complaints.

According to Western Medicine
 

     There are three major categories of headaches: primary headaches, secondary headaches, and cranial neuralgias, facial pain, and other headaches. Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache. Tension headaches are the most common type of primary headache. Up to 90% of adults have had or will have tension headaches. Tension headaches occur more commonly among women than men.  Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience a migraine headache. Migraine headaches affect children as well as adults. Before puberty , boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. It is estimated that 6% of men and up to 18% of women will experience a migraine headache in their lifetime. Cluster headaches are a rare type of primary headache affecting 0.1% of the population (1 in a 1,000 people). It more commonly affects men in their late 20s though women and children can also suffer these types of headache. Treatment of headaches in Western Medicine ranges from medications to lidocaine injections.

According to Traditional Chinese Medicine 

       Traditional Chinese Medicine has a very different approach to understanding, diagnosing and treating headache symptoms. Headache is seen as a symptom of underlying disease as well as an independent disease. Syndrome differentiation for headache patterns is based on symptoms of headache itself and accompanying symptoms. There are few major syndromes that can be differentiated:

Wind Cold Pattern. Symptoms include: sporadic pain, stiff, aching shoulders; an aversion to cold temperatures; aggravation of the condition by wind; absence of thirst. Reason for headache symptom: When the wind cold invades the body it usually affects the Urinary Bladder meridian which governs the surface of the body and its obstruction induces headache.

Wind Heat Pattern. Symptoms include: a painfully-swollen sensation in the head; severe, "splitting" pain; fever, or an aversion to warm temperatures; red face; red eyes; thirst; constipation; dark-colored urine. Reason for headache symptom: Wind heat usually invades the body it disturbs head orifices like nose, throat and mouth and leads to headache symptoms with distending or splitting sensation and causing flushing face sensation.

Wind Dampness Pattern.Symptoms include: heavy-feeling pain; a "fuzzy," or confused feeling; a feeling of heaviness in the whole body; chest congestion; aggravation of symptoms by damp weather; difficult urination; loose bowels. Reason for headache symptom: When wind pathogen invades the body it also obstructs head orifices leading to headache with a feeling like the head is wrapped in a tight towel or headband.  

Liver Yang Pattern. Emotional disturbance (especially feelings of anger) is the primary origin of this pattern. Symptoms of the pattern include: pain with dizziness; anxiety; anger; insomnia; hypochondriac (under the ribcage) pain; red face; a bitter taste in the mouth. Reason for headache symptom: the hyperactive Yang tends to affect upper body and obstructs Liver meridian which runs through the sides of the head so headache due to Liver Yang rising will cause temporal headaches or migraines.

Kidney Deficiency Pattern. General weakness is the basic cause of this pattern. Symptoms include: low-level pain with a feeling of "emptiness"; dizziness; sore back; fatigue; spontaneous seminal emissions (in men), or abnormal vaginal discharge (for women); ringing in the ears; sleeplessness. Reason for headache symptom: Kidney-deficiency will lead to depletion of essence and blood and malnourishment of the brain, so headache is one of the symptoms that will appear.

Blood Deficiency Pattern. Chronic illness or loss of blood is the cause of this pattern. Symptoms include: pain with dizziness; heart palpitations; fatigue; pale complexion. Reason for headache symptom: Since the blood is important component of yin then blood deficiency will lead to yin/yang imbalance and unrestrained yang will affect the upper part of the body here meaning head and also malnourishment of the brain both can induce the symptom of headache.

Blood Stagnation Pattern. Symptoms include: chronic pain; pain in a fixed location; sharp pain, such as pain from a head injury. Reason for headache symptom: Blood stagnation leads to obstruction of small collaterals of the head and lead to a local stabbing pain in the head.

Phlegm Retention Pattern. Chronic over-weight or the habitual consumption of sweet and fatty foods are the main cause of this pattern. Symptoms include: dull head pain with a feeling of heaviness and/or fuzziness; a sensation of fullness and oppression of the chest; a feeling of nausea and phlegm retention in the throat. Reason for headache symptom: When phlegm accumulates it impairs ascending of clear Yang and symptoms of headache will appear.

     Following location of the headache it usually follows the meridian and its corresponding organ being affected. So all over the head pain can be a sign and can be induced by Liver and Kidney yin deficiency or deficiency of blood and Qi. Occipital head or neck is induced by hyperactive Yang, or external wind such as wind cold. Vertex headaches can be initiated by cold, or following obstructed Liver meridian which ascends to vertex. Sides of the head pain is induced by Liver-fire. Frontal headaches involving eyebrow region involve obstruction of the Stomach meridian. Phlegm can also prevent Qi from descending and the pure Yang from ascending freely to the head, causing headaches. Headache accompanied by sore throat or tooth ache can be induced by Kidney meridian obstruction. Headache with heavy "band around" like sensation is related to dampness accumulation or Spleen dysfunction leading to dampness accumulation.

 Clinical Research 

      TCM treatments include all modalities of Traditional Chinese Medicine, but mostly employed are acupuncture and herbal therapies. As is confirmed by research both have proved to be beneficial for headache treatments.  

       According to one study the treatment in the hospital for traditional Chinese medicine in Kotzting is associated with lasting improvements in the majority of patients. Ninety-one patients with migraine, episodic or chronic tension-type headache according to the criteria of the International Headache Society were randomised into an experimental or a waiting list control group. Patients in the experimental group were treated 4 weeks in a hospital for traditional Chinese medicine after a baseline period of one month. Patients in the waiting list group continued their previous headache treatment. Main outcome measure was the difference in the number of days with headache of at least moderate intensity during baseline (month 1) and month 7. The difference in the number of days with headache of at least moderate intensity was 5.6 (S.D., 6.1) days in the experimental group and 1.2 (S.D., 4.5) days in the waiting list group (P <0.001). A reduction of more than 50% in headache days was observed in 52% of the patients in the experimental group and 16% in the waiting list group. Patients with migraine and a combination of migraine and episodic tension-type headaches improved more than patients with other headaches.

     TCM also successfully treats migraine patients. In another study 32 out-patients enrolled in this study and met the diagnostic criteria for migraine headaches. After TCM syndrome differentiation they were all treated with formula Yang Xue Chu Feng Tong Luo Tang. Cure was defined as complete disappearance of the headaches and all accompanying symptoms with no recurrence within half a year. Based on these criteria, 24 cases were judged cured, six cases got a marked effect, and two cases improved.

    TCM treatments also benefit those suffering from premenstrual headaches.   48 patients enrolled in this study were seen as outpatients at Ping Ding Shan Municipal Chinese Medical Hospital. Cure was defined as complete disappearance of migraines with no recurrence on follow-up after one year. Marked effect was defined as basic disappearance of migraines or marked decrease. Some effect was defined as varying degrees of reduction in migraines, which occurred less frequently and lasted less time. No effect meant that there was no obvious improvement in premenstrual migraines. Based on these criteria, 23 out of 48 patients in the treatment group were cured, 13 experienced a marked effect, 10 got some effect, and two got no effect. Therefore, the total effectiveness rate in the treatment group was listed as 95.83%.

Sources

"Treatment of patients with chronic headaches in a hospital for traditional Chinese medicine in Germany. A randomised, waiting list controlled trial." Melchart D, Hager S, Hager U, Liao J, Weidenhammer W, Linde K. Complement Ther Med. 2004 Jun-Sep;12(2-3):71-8.

"The Treatment of 32 Cases of Migraine Headache by Yang Xue Chu Feng Tong Luo Tang (Nourishing the Blood, Dispelling Wind & Freeing the Flow of the Network Vessels Decoction)." Huang Qiao-zhi, Shan Xi Zhong Yi (Shanxi Chinese Medicine), #5, 2003, p. 19-20

"The Chinese Medicinal Treatment of 48 Cases of Premenstrual Migraine"., Sun Hong-li, Xin Zhong Yi (New Chinese Medicine), #2, 2003, p. 52-53

 

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TSTCM offers professional training programs in Acupuncture and Traditional Chinese Medicine and provides supervised health services in Traditional Chinese Medicine, acupuncture, Chinese herbal remedies, and Tuina massage to our local community and beyond.

 

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