Acupuncture and Herbs for Migraine Headaches
Chief Complaint: Migraines
Medical History: Patient M is a 32 year old Italian Male who resides in Los Angeles, California and works for a moving company. He presented in my office two years ago with complaints of Migraine headaches that he has had since he was a child. He has tried taking medication for his headaches, but they have not helped.
Since Mr. M was about twelve years old he has experienced migraine headaches about every other week. These headaches last for about one day and range from moderate to severe. Unless his headaches are severe the patient continues to go to work and perform his daily activities. He reports that his headaches feel like pressure inside his head and can sometimes feel like stabbing pain. His usually experiences them on only one side, but that sometimes it is the left and sometimes it is on the right, but never both sides in one episode.
Mr. M also repots that when he feels stressed out or overwhelmed he will get a headache. Additionally the patient states that typically if he oversleeps, more than 6-7 hours, he will experience a migraine. Lastly he reports that jet lag and drinking wine will trigger a migraine.
Further, this patient states the he will have periods of hyperactivity where he works, spends time with his friends and is highly active for about 2 to 3 days. Then afterward he will experience a time of incredibly low energy where he is not able to leave the house. Mr. M reports that he is able to sleep but when he wakes up he does not feel rested.
Currently this patient is not taking any pharmaceutical medications or herbal supplements. He denies any history of hypertension, heart disease, diabetes, arthritis, chest pain, breathing problems or any genetic or autoimmune disease. Mr. M denies any history of accidents, major traumas, illnesses or surgeries.
The patient is a social smoker, social drinker and uses marijuana. He denies any other illicit or prescribed drug use. His diet includes infrequent meals, usually of fast food and foods high in fat such as red meats and cheeses. Since this patientâ€™s job is physically demanding he does not get any other exercise. He also sleeps infrequently sometimes getting eight or more hours and sometimes having as little as three.
Mr. M reports that high cholesterol runs in his family from his fatherâ€™s side and that he is not aware of any other inherited diseases. Both of his parents are still alive and doing relatively well. He is not sure as to how his grandparents passed away.
The patient works as a mover for a small moving company. He feels satisfied with his job although it requires long hours and hard physical labor. Mr. M does not state that he practices any particular faith. His family does not reside in this country, but the patient states that he has friends who he goes out with during his free time. These migraines seem to be a great source of stress in his life. Furthermore I attempted to gain information as to any occurrence he might remember when he was a child that might have started his migraines. Mr. M did not have any idea.
Questioning exam: Other accompanying symptomology include sweating, sound and light sensitivity, loss of appetite and nausea. Patient M reports that for the most part his migraines attack spontaneously, however he is aware of a few triggers. The patient reports that he is too busy to eat a regular diet and that after a period of fasting he will experience a migraine a couple hours after he finally eats.
In addition to the above mentioned symptoms this patient also reports having problems with bloating, gas and constipation. He experiences fatigue often. He does not report having cold hands or feet, vision problems or odd tastes in his mouth.
Pulse exam: His right pulse was wiry and slow while his left was weak, wiry and slow.
Tongue exam: His tongue body was of normal color with a red tip and red sides. It had a thin white coat.
OM Diagnosis: Liver Qi stagnation invading spleen and stomach with Qi and blood deficiency.
From Mr. Mâ€™s history it is obvious that his periods of hyperactivity and stress combined with irregular sleep and unregulated diet is causing his liver to stagnate. From his symptoms it seems that the liver is also invading the spleen and stomach, but at the same time his diet is insulting those organs simultaneously. The fact that many of his migraines are triggered after he finally eats or sleeps indicates that his liver is trying to discharge the stagnation. This is a common event by which the relaxation releases the stagnation that had been occurring and the energy flows upward all at once not unlike opening a dam.
Coexisting factors seen in his pulses and the fatigue indicate a spleen Qi deficiency. He also exhibits symptoms of liver invading spleen such as the gas and bloating. The constipation is more likely coming from the stagnant qi. The stagnation and spleen depression damp are combing into heat which rises to the head and causes patient Mâ€™s migraines. The heat is seen is his periods of hyperactivity, red eyes and sweating during the headaches. After which he experiences a day of so of pronounced fatigue indicating the deficiencies.
Treatment Principle: The treatment principle in this case should be to regulate and smooth liver qi while supplementing the spleen. Since the heat, damp and blood deficiency are not as evident as the stagnation, these three related conditions should rectify with the moving of liver Qi and the supporting of the spleen.
Point Prescription: LI 4, LV 3. These two paired points are well known for moving stagnant qi of the whole body. LV 3 also specifically moves Qi and rectifies the liver.
GB 41 or 43. I felt for tender spots and ended up usually using one on each side. These points drain heat and bring Qi down.
GB 8. This is an empirical point for migraines. It is a paired channel relationship with the liver. Since it is a local point as well it can free the flow of network vessels.
SP 6. This is the meeting point of the spleen, liver and kidney. It can move stagnant liver qi as well as tonify the spleen.
Herbal Formula: A modified Xiao Yao San to course the liver adding 18 grams of Chuan Xiong to quicken the blood and stop pain with 15 grams of Huang Qi to tonify Qi. This formula also aids in supplementing the spleen and blood. With this formula it is necessary to exercise caution. Chai Hu is contraindicated for any upward moving Qi, but it is an essential herb in rectifying the liver. So it must be stir fried with vinegar and combined with Bai Shao. This will limit the herbs upward flow.
Lifestyle Prescription: The patient was given recommendations to eat at least three regular meals and set a regular time for sleep each night. His diet is to avoid all products with nitrates and tyrosineâ€™s such as; pickled or fermented foods, salami, bacon, aged cheeses, wine, beer and chocolate.
Results: The patient was never very compliant and only came when his headaches were getting worse, but after just two treatments the patient reported that his migraines had decreased from every other week to only once a month. After about three more treatments the patient disappeared completely.
Then after two years M called and setup another appointment. It turns out that he had stopped having his headaches altogether. That was until about a month prior to when he called. He had just got engaged and work had also picked up so he was very busy and was feeling a lot of stress. I treated him twice more with the same acupuncture points and again have not heard from him since.
Clinic Name: Christopher Salah, DAOM., L.Ac.
clinic address: 833 Bridgeway
Sausalito, Ca 94965
clinic phone number: 415.324.5845
email address: firstname.lastname@example.org