Headache


Jennifer D., Van Nuys, California, 2004. Migraine headache.

Jennifer, 39 years old RN, worked full time in the Pediatric Intensive Care Unit of UCLA Medical Center presented with migraine headache, depression, chronic back pain and PMS. She suffered migraine headache since her 23 with as much as 2 weeks out of one month. Ponding in one side of head, twitching of frontal muscle and aversion of light were the main symptoms occurred during attacks. Analgesics could not help to relieve her headache. She also found that her memory was progressively declining.  All the symptoms frequently associated with her menstrual periods. As working in such an intensive environment she developed depression and fatigue adding to the desperate headache. The first acupuncture was given on 2/18/04 and followed on 2/20, & 3/2. She came back on 3/12 for depression treatment. After the last treatment, she did not experience any migraine or PMS symptoms. Two more treatments had been given and the last one was given on 3/23/04.  

On 1/19/05 she came to our clinic for stress treatment. She told us that she only have mild headache during each period for two days and can control very well with one Tylenol.

Ahahin A., Tarzana, California, 2008. Tension headache.

Ahahin, 56 years old, presented with constantly headache in various degree since she was 12 years old. The headache was dull in nature and more severe in the evening. She started to be Menopausal for 2 years. She was a type II diabetic sufferer and controlled with oral hypoglycemic drug. She also experience moderated pain in the neck and upper shoulders frequently. She used Naproxen for her aching. We saw her the first time on 3/17/08 and plan to provide her two acupunctures a week for her headache, and neck pain.  Her symptoms of headache and neck pain was started to improve at the 4th treatment and improve progressively. Total 8 treatments she had received and her symptoms were 75% less. Following up her condition, we were told that her headache became very infrequent with only mildly degree.     

 

More than 45 million of Americans suffer from chronic headache, half of them are women. The brain itself is not sensitive to pain because it lacks pain receptors. However, several areas of the head and neck do have pain receptors, named nociceptors, and can thus feel pain. Headache often results from traction the blood vessels and meninges.

Tension headache. Tension headache is the most common type of headache which is likely caused by tight muscles in the shoulders, neck, scalp, and jaw. It may be related to stress, depression, anxiety, head injury, or holding the head and neck in an abnormal position.

Migraine headache. Migraine is severe headache that usually occur with “aura” and other symptoms such as vision changes or nausea. Migraine may be triggered by certain foods, alcohol, or lack of sleep.

Rebound headache. Rebound headache that may occur from overuse of painkillers. Patients who take pain medication more than 3 days a week on a regular basis can develop this type of headache.

Headache can caused by sinus infection, flu, fever, PMS, tumor, high blood pressure, hydrocephalus, trauma, or arteritis.

Headaches dramatically reduced by Acupuncture

Oriental Medicine does not recognize migraines and chronic headaches as one particular syndrome. Instead, it aims to treat the specific symptoms that are unique to each individual using a variety of techniques such as acupuncture, to restore imbalances found in the body.

Since the early seventies, a tremendous amount of studies around the world have suggested that acupuncture is an effective treatment for migraines and headaches. According to a new analysis conducted by Duke University Medical Center researchers, acupuncture is more effective than medication in reducing the severity and frequency of chronic headaches,

Researchers analyzed the results of more than 30 studies on acupuncture as a pain reliever for a variety of ailments, including chronic headaches. The studies included nearly 4,000 patients who reported migraines (17 studies), tension headaches (10 studies) and other forms of chronic headaches with multiple symptoms (four studies). In 17 studies comparing acupuncture to medication, the researchers found that 62 percent of the acupuncture patients reported headache relief compared to only 45 percent of people taking medication. These acupuncture patients also reported better physical well-being compared to the medication group. In 14 studies that compared real acupuncture to sham therapy, 53 percent of acupuncture patients responded to treatment compared to 45 percent receiving sham therapy. They found that acupuncture decreases pain with fewer side effects and can be less expensive than medication. Researchers found that using acupuncture as an alternative for pain relief also reduced the need for post-operative pain medications.

“One of the barriers to treatment with acupuncture is getting people to understand that while needles are used it is not a painful experience,” Dr. Gan, the reseracher says. “It is a method for releasing your body’s own natural painkillers.”

What we do

Standard steps we approach to patient with headache:

1. Record detail history of illness to sort out the cause of headache.

2. Review test data and imaging result (X-ray, CT scan, MRI).

3. Perform thoroughly physical examination to come up a diagnosis.

4. Propose a treatment plan.

5. Common acupuncture points used include: Ear sympathetic, subcortex, brain; shu points of the large intestine channel and liver channel; analgesic points; and hormone balance points (for women). Local trigger points for neck or shoulder muscle problems.

6. Add Electric stimulation or cupping as needed.

Demography of headache patient and treatment results of our clinic

Study data draw from 2003 to 2007. Age: 45 to 80, average 63. Gender: F: M=3:1

Diagnosis % of total pain patients % of Improvement % of marked improvement Average treatment

Headache

1.73 90 70

8

Literature review

Yang DH, et al. Migraine without aura treated by comprehensive auricular acupuncture: a multicentral controlled study. Zhongguo Zhen Jiu. 2012 Nov;32(11):971-4.

Ninety patients of migraine without aura from three centers were selected as the study subjects. Thirty cases from each center were treated with the comprehensive auricular acupuncture. The therapy was applied once every 7-10 days. The continuous 3 treatments made one session.

At the end of one session for the patients in three centers, the headache scores were reduced apparently as compared with those before treatment. There was no statistically significant difference in comparison among three centers. The clinical total effective rates were 93.3% (28/30), 90.0% (27/30) and 93.3% (28/30) in three centers separately. 

The comprehensive auricular acupuncture reduces apparently the headache score for migraine without aura and relieves the clinical symptoms of migraine. It is the simple and effective therapy for migraine without aura.

Melchart D, et al. Acupuncture for idiopathic headache. Cochrane Database Syst Rev. 2001;(1):CD001218. Updated in Cochrane Database Syst. Rev. 2009;(1):CD001218.

Randomized or quasi-randomized clinical trials comparing acupuncture with any type of control intervention for the treatment of idiopathic (primary) headaches were included.

Twenty-six trials including a total of 1151 patients met the inclusion criteria. 16 trials were conducted among patients with migraine, 6 among patients with tension-type headache, and 4 among patients with various types of headaches. The majority of trials had methodological and/or reporting shortcomings. In 8 of the 16 trials comparing true and sham acupuncture in migraine and tension-type headache patients, true acupuncture was reported to be significantly superior; in four trials there was a trend in favor of true acupuncture; and in two trials there was no difference between the two interventions. The 10 trials comparing acupuncture with other forms of treatment yielded contradictory results.

Overall, the existing evidence supports the value of acupuncture for the treatment of idiopathic headaches. However, the quality and amount of evidence are not fully convincing. There is an urgent need for well-planned, large-scale studies to assess the effectiveness and cost-effectiveness of acupuncture under real-life conditions.

Lide K, et al. Acupuncture for tension-type headache. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD007587. doi: 10.1002/14651858.CD007587.

To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than ‘sham’ (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in patients with episodic or chronic tension-type headache.

The authors included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another intervention in patients with episodic or chronic tension-type headache.

Eleven trials with 2317 participants (median 62, range 10 to 1265) met the inclusion criteria. Two large trials compared acupuncture to treatment of acute headaches or routine care only. Both found statistically significant and clinically relevant short-term (up to 3 months) benefits of acupuncture over control for response, number of headache days and pain intensity. Long-term effects (beyond 3 months) were not investigated. Six trials compared acupuncture with a sham acupuncture intervention, and five of the six provided data for meta-analyses. Small but statistically significant benefits of acupuncture over sham were found for response as well as for several other outcomes. Three of the four trials comparing acupuncture with physiotherapy, massage or relaxation had important methodological or reporting shortcomings. Their findings are difficult to interpret, but collectively suggest slightly better results for some outcomes in the control groups.

Author’s conclusions: In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches

Li Y., et al. Acupuncture for treating acute attacks of migraine: a randomized controlled trial. Headache. 2009 Jun;49(6):805-16. doi: 10.1111/j.1526-4610.2009.01424.x. Epub 2009 Apr 27.

A total of 175 patients with migraine were recruited for the study, and were randomized into 3 groups. One group received verum acupuncture while subjects in the other 2 groups were treated with sham acupuncture. Each patient received 1 session of treatment and was observed over a period of 24 hours. The main outcome measure was the differences in visual analog scale (VAS) scores before treatment and 0.5, 1, 2, and 4 hours after treatment.

Significant decreases in VAS scores from baseline were observed in the fourth hour after treatment when VAS was measured in the patients who received either verum acupuncture or sham acupunctures. At the second hour after treatment, only patients treated with verum acupuncture showed significant decreases in VAS scores from baseline. The VAS scores in the fourth hour after treatment in the verum acupuncture group decreased significantly. Significant differences were observed in pain relief, relapse, or aggravation within 24 hours after treatment as well as in the general evaluations among the 3 groups. Most patients in the acupuncture group experienced complete pain relief (40.7%) and did not experience recurrence or intensification of pain (79.6%). Conclusion: Verum acupuncture treatment is more effective than sham acupuncture based on either Chinese or Western nonacupoints in reducing the discomfort of acute migraine. Verum acupuncture is also clearly effective in relieving pain and preventing migraine relapse or aggravation. These findings support the contention that there are specific physiological effects that distinguish genuine acupoints from nonacupoints