The Acupuncture Treatment of Headaches
Chief Complaint: Chronic headaches: Tension, sinus, and migraine headaches
Medical History: 29 year old female; occupation-Project Coordinator for a construction company.
States to condition of “chronic” headaches for past 6+ years. Suffering from three types of headaches: tension, sinus and migraine headaches. Wants to get off “so many” medications that many times don’t work.
Reports father diagnosed with cluster headaches.
Current medications: Advil and Aleve for tension H/A, Sudafed 12 hr. for sinus H/A (preventative), Amitryptaline, Midrin, Fioracet for migraine H/A, Orthonovum 1/35 oral contraceptive. Other history is unremarkable.
Questioning exam: Tension headaches: Start at the back of the neck, then pain is felt at the cheekbones, then the pain travels to the shoulders, then to the jaw at its most involved status. All types of stress cause the onset of symptoms. Frequency – 10-12/month. Duration – up to 3 days. Moist heat and movement lessens pain levels. Use of Advil or Aleve also lessens pain levels if taken immediately at onset of pain.
Sinus headaches: Pain is felt at the front of the face but more prominently behind the eyes. The pain is stabbing; “feels like my eyeballs are being pushed out of their sockets from the pressure.” Bending over increases pain levels. Dizziness occurs when standing during this type of H/A. Frequency – 7/month. Duration – 4-6 hours. Drinking hot liquids helps lessen pain levels. These H/A occur if constant regiment of Sudafed 12 hr. is missed, and sometimes even if regiment is followed.
Migraine headaches: A combination of the tension and sinus H/A symptoms with the additional symptoms of nausea, photophobia, auditory sensitivity and the feeling of a spike in her head from the acupoint SI18 to the acupoint GB14 on the left side. Has had a total of 4 of these migraines. Zero in the past year since prescribed amytryptaline.
Also states right sided hip/leg pain starting from GB30 following the GB channel and ending at GB34. Pain comes on with inactivity such as during driving, sitting at the desk. Movement help decrease pain levels.
Sleep: Has restless sleep, doesn’t feel fully asleep or get fully awake during night. Gets 7-8 hours/night but wakes-up not feeling rested. High stress levels during the day can make it difficult to fall asleep.
Ob/gyn: Menarche-16. Cycle – 28/3 on oral contraception. Has been on O.C. for past 12 years. Initial reason was to regulate menstrual cycle. Before O.C. menstrual flow lasted 7 days and bleeding was heavy.
Remainder of 10 questions were unremarkable.
Pulse exam: Overall the pulse was moderate speed, tight, and fatigued. The LU, LV and KD positions were deficient.
Tongue exam: Tongue: The tongue body was thin and its color was slightly purplish. The tip of the tongue was red. The tongue coat was thin white and even over the tongue.
OM Diagnosis: Constrained Liver qi – Stress induces the LV qi to become constrained causing the various types of H/As. The H/As show the signs of LV/GB implication: GB meridian at the back of the neck, LV involvement with the pain behind the eyes, etc. Waking-up and falling asleep frequently is also indicative of Liver qi constraint.
Qi deficiency – LV constraint causes an inability for the body to rest properly. Over the long term this has caused an overall qi deficiency.
Stagnant blood/qi in Gall Bladder channel – Directly related to the hip/leg pain along the GB channel.
Treatment Principle: Smooth the Liver; build qi; move stagnant blood/qi in the Gall Bladder channel
Point Prescription: GB20, BL13, BL15, BL18, BL23 (to root), SI11 (stimulate until qi spreads over shoulder and down the arm). Retain all for 15 min.
Yin tang, LI4, CV12, GB34, ST36, SP6, LV3. Retain all for 15 min.
TDP heat lamp on lower back and navel/lower abdomen to build qi and to help pull qi down out of the head and root the qi.
Herbal Formula: N/A
Lifestyle Prescription: A lifestyle suggestion to make some more personal time daily to decompress and not have any responsibilities.
Results: A series of 11 treatments over 14 weeks results have been overall very good. She has had only 3 major H/As, 1 tension H/A and 2 sinus H/A. A significant reduction from 10-12/month of tension H/A and 7/month of sinus H/A. The right hip pain frequency, duration and intensity is also reduced. Treatment at present is continuing on a bi-weekly/as needed basis.