Considering that migraine is one of the most common illnesses in the world, affecting about 1 in seven people and is first mentioned by Hippocrates in around 400BC its remarkable how little we actually know about the condition. It seems to have a genetic component and often runs in families. Its more common among women than men. It used to be thought that migraine was a disease of the blood vessels (in the brain), but it is now thought that migraine is a brain disease. But we still don’t know why exactly why people get migraines or exactly what causes them and while there are some new treatments being developed many sufferers are still advised to take some over the counter painkillers and lie in a darkened room.
Perhaps part of the problem is that Western Medicine is looking for a single cause for something that isn’t actually a single thing. Alongside the headache, sufferers may experience a wide range of other symptoms, which may include any of the following; nausea, vomiting, visual disturbances, increased sensitivity to light, sounds and smells, vertigo, pins and needles and fatigue. From the perspective of Chinese Medicine each of these symptoms, or combinations of them, together with the part of the head where the pain is most intense and how the patient describes the pain may all point to different patterns of imbalance underlying the patient’s symptoms.
A common presentation of a migraine might include a temporal, often one-sided headache with distending pain, sensitivity to light and possibly some nausea and vomiting. Chinese medicine might describe this as Liver Yang rising assuming other signs, such as the pulse supported such a diagnosis. Liver Qi has a tendency to rise and when excessive to cause stagnation in the meridian of its paired organ, the Gallbladder (the Liver is Yin and the Gallbladder Yang). The Gallbladder meridian runs across the temporal region of the head and so this is where the pain is located. The Liver is also said to open into the eyes and so disharmony in the Liver Qi would explain the visual disturbance and sensitivity to light that often accompanies migraines. From the perspective of a 5 Element acupuncturist the above symptoms would correspond to the Wood and Earth Elements, which in turn correspond to the Liver & Gallbladder and the Stomach & Spleen. So a Five Element practitioner might describe this pattern as Excessive Wood overacting on Earth and this would explain the nausea and vomiting, essentially excessive Liver Qi rising and inhibiting the correct descending of Stomach Qi.
To a Western ear all this may sound somewhat nonsensical but these descriptions only matter in so far as they allow the practitioner to develop an individualised treatment protocol. Were the pain fixed and stabbing and in a different location on the head then the diagnosis would be different (stagnation of Qi and Blood) and treatment altered accordingly. In fact Traditional Chinese Medicine would distinguish four patterns of disharmony within the body that result in migraines as well as a number of external factors like Wind-Cold and Wind-Dampness that may lead to a migraine. It seems to me that it’s these broader diagnostic criteria and the variation of treatment based upon them that make acupuncture such an effective therapy for migraine.
Its not my intention here to try and write a definitive article on migraine from the perspective of Chinese Medicine. What I do want to suggest is that for those suffering from migraine Chinese Medicine should probably be their first option with regards treatment. There’s actually research to back this up. A randomised controlled trial (RCT) conducted in Italy and published in the March 2008 issue of the journal ‘Headache’ reported significant improvement in outcomes for patients receiving traditional acupuncture over those receiving sham acupuncture or those prescribed Rizatriptan, a commonly prescribed migraine medication. Not only did those receiving acupuncture show the greatest improvement in their symptoms but these improvements were sustained 6 months later. You can access the full paper here. Or read a summary here.
When I was training as an acupuncturist we all spent a lot of time learning the ‘Red Flags’ of serious disease. These are the signs and symptoms a patient may present with that suggest they need an immediate or urgent referral to a GP or even A&E. Being cognisant of such things is part of my offering my patients the best care I can and should they need such a referral I’m very happy to make it. But writing this it occurred to me that perhaps there are some conditions that GPs should be referring to acupuncturists. I’d put migraine at the top of that list.
Bruce Bell is a fully qualified 5 Element acupuncturist working from clinics in Midsomer Norton and Keynsham.