Acupuncture Treatment of Chronic Migraine Headaches

Neurological

Chief Complaint: Chronic headaches

Western Diagnosis: Migraine headaches

Medical History:

Sylvia, a thirty five year old woman from St. Petersburg, suffered from severe migraine headaches for four years following the birth of her third child. A very hard-working college student and single mother with a full-time job, she felt over-stressed during waking hours and hardly had time for sleep.

The headaches were pounding, causing waves of nausea, sore eyes with diminished vision, a hot painful head. The pain was located mostly at her temples and sometimes behind her left eye. She would lay down in a dark room with a cold washcloth on her eyes, praying for the pain to stop. She also experienced angry outbursts and tearfulness, particularly during the week before her menstrual cycle. She could not sleep most nights. When someone asked her how she felt, she would always answer exhausted. Four years of conventional treatments had not produced lasting results, and a friend convinced her to try oriental medicine.

When she came in for treatment, she filled out six pages of questionnaire that asked for very particular details concerning her sleep, appetite, habits, likes and dislikes, sweating patterns, bowel movements and many other areas of her life. The questionnaire, like the oriental medical examination, was focused upon obtaining as much information as possible about Sylvia in order to understand the patterns of disharmony behind her symptoms. Emotional patterns, relationships, exercise habits, diet and even thinking habits were included in the determination of her differentiation. The treatment would aim at restoring harmony and balance in Sylvia’s energy, in her bodily functions, in her mind, and in her life.

Sylvia’s pulse was taken, her tongue was examined. In oriental medicine the pulse displays the state of the internal organs and reflects the complexity of qi (life force) and blood. There are many voluminous works describing the infinity of possible combinations and interpretations of the pulse in Chinese medicine. Likewise, the tongue’s body color, coating color, shape and moisture reveal the quality of qi and blood (as does the pulse), along with body fluids and the various yin and yang organs. The tongue can also show signs that the body has been invaded/attacked by something from the outside (virus, bacteria, cold, etc.) Sylvia laughed when her tongue was examined, because her tongue coating was grape-colored. She had been drinking Juicy Juice with her child in the waiting room.

In traditional Chinese medicine there are four areas of pain focus that help to differentiate a headache. As in pulse and tongue diagnosis, the possibilities are endless, but to simplify in terms of location: a facial headache often relates to the Stomach channel, an occipital (back of the head) headache relates to the bladder channel that runs down the back, the very top of the head relates deficiencies in the liver channel and organ, and the sides of the head, where Sylvia felt her pain the most, are affected most by excess energy in the Liver and Gallbladder meridians (and organs).

There are countless other factors involved in differentiating a headache in chinese medical theory. From the huge number of signs and symptoms, the physician must begin to shape the possibilities into a coherent whole. The final differentiation is a work of art: more of a collage than a sculpture. The etiology (origin )of the headache requires that all of these factors be considered: the patient’s constitution, emotional patterns, diet, history of accidents and injuries, childbirth, work habits (particularly damaging is overworking long hours), and external influences such as the weather, exposure to external pathogens (described as wind, damp, heat, cold, etc. in Chinese medicine) including pollution, air-conditioning, etc. For a headache, the most important questions asked are: is it interior or exterior? Is the headache primarily an excess or a deficiency? What makes it feel better and what makes it feel worse? Sylvia was asked all of these questions and more. As she further described her headaches, this picture emerged: Her headache was throbbing, relieved by cold, worse with pressure, stronger in the evening, worse with activity, worse with heat or on a hot day, very much influenced by anger, frustration and ex-husband, perhaps worse with her favorite spicy foods and beer, and a little bit better when lying down but sometimes worse when lying down.

In Sylvia’s pattern of disharmony, all of the detailed information produced a description unique to her. The rapid, wiry and thin pulse combined with her crimson-tipped, scalloped, quivering, yellow coated (per her report, it was not usually grape-colored) tongue, pointed towards a traditional pattern in oriental medicine. Her headaches appear to be primarily internal, excess type strongly influenced by emotional factors. In Chinese medicine, the organs most affected by Sylvia’s emotional patterns would be the Liver, Heart and Lungs. The pathogenesis (the map of the disease) continues as follows: Sylvia’s frequent anger and frustration are signs that Liver energy is stuck, that it is constricted and creating problems. Over a long time, stuck Liver energy injures the Heart (where the Mind is primarily located) and Lungs, and turns to Liver Fire. The headaches that she experienced on the side of her head, along with the emotional outbursts of anger, depression, pain in the neck and shoulders, frequent sighing, red painful eyes, insomnia, dream-disturbed sleep further confirmed the differentiations of Liver Qi stagnation with Liver fire rising. Her treatment was first directed at stopping the pain in her head by reducing the liver fire, then calming her mind, and lastly at resolving her habitual liver qi stagnation. Acupuncture was used to balance energy, draw liver yang and liver fire down from the head, strengthen yin, soothe the Mind.

How did she feel? Sylvia said, I felt wonderful, relaxed, grounded like I haven’t felt in years. This was from the first treatment. She took the herbal formula Long Dan Xie Gan Wan for two weeks, then used Jia Wei Xiao Yao Wan religiously for the rest of the year. After one year of treatment, she has not had a single migraine. She reported one headache in the past six months, and that was probably caused by too much red wine at a party. Her sleep has improved, too.

Sylvia was also given a large number of suggestions/directives that have turned out to be very important to her improved health. Oriental medicine, as all holistic medicines, looks to harmonize the whole person. Along with the herbs and the acupuncture, but she also found it important to change her diet, exercise patterns, working environment, recreation (a reduction of the noise of the television), a renewed emphasis on prayer (her strong point), sleep improvement by way of some special techniques and even her thoughts were examined as they relate to her goals of harmonizing her life. She had work to do on herself on a daily basis in order to help herself get better. Sylvia did the work and is enjoying the rewards.

What about the costs? Sylvia spent slightly more on acupuncture and herbs than she had been spending on prescriptions, doctors visits, over the counter sleep aids, etc. However, she has not missed any days from work or from school due to migraine headaches. She said, my head doesn’t hurt and I sleep much better. For her, this improvement in the quality of her life has made a huge, lasting difference. To experience her new health and increased happiness has been quite enjoyable for her friends, family and acupuncturist.

Questioning exam: the headaches were pounding, causing waves of nausea, sore eyes with diminished vision, a hot painful head. The pain was located mostly at her temples and sometimes behind her left eye. She would lay down in a dark room with a cold washcloth on her eyes, praying for the pain to stop. She also experienced angry outbursts and tearfulness, particularly during the week before her menstrual cycle. She could not sleep most nights. When someone asked her how she felt, she would always answer exhausted. Her headache was throbbing, relieved by cold, worse with pressure, stronger in the evening, worse with activity, worse with heat or on a hot day, very much influenced by anger, frustration and ex-husband, perhaps worse with her favorite spicy foods and beer, and a little bit better when lying down but sometimes worse when lying down.

Pulse exam: Sylvia’s pulse was taken, her tongue was examined. In oriental medicine the pulse displays the state of the internal organs and reflects the complexity of qi (life force) and blood. There are many voluminous works describing the infinity of possible combinations and interpretations of the pulse in Chinese medicine. Likewise, the tongue’s body color, coating color, shape and moisture reveal the quality of qi and blood (as does the pulse), along with body fluids and the various yin and yang organs. The tongue can also show signs that the body has been invaded/attacked by something from the outside (virus, bacteria, cold, etc.) Sylvia laughed when her tongue was examined, because her tongue coating was grape-colored. She had been drinking Juicy Juice with her child in the waiting room.

Her pulse was wiry rapid on the left side, and thin.

Tongue exam: her tongue was (when seen without Juicy Juice) dry and very red at the tip and on the sides.

OM Diagnosis: Liver Depression/Qi Stagnation turned to Liver Fire Rising.

Treatment Principle: Soothe the Liver, Quench Fire, Calm Shen, Stop Pain,

Point Prescription: points: LI4, LR3 , LR2

GB20, GB21

Yintang, Ear Shen Men

GB34, SP6

Herbal Formula: Long Dan Xie Gan Wan

Jia Wei Xiao Yao Wan

Lifestyle Prescription: Tui Na

Lifestyle changes: resume exercising, release the ex-husband, continue to pray, more time for sleep and recreation, less work

Results: Sylvia said, I felt wonderful, relaxed, grounded like I haven’t felt in years. This was from the first treatment. She took the herbal formula Long Dan Xie Gan Wan for two weeks, then used Jia Wei Xiao Yao Wan religiously for the rest of the year. After one year of treatment, she has not had a single migraine. She reported one headache in the past six months, and that was probably caused by too much red wine at a party. Her sleep has improved, too.

Clinic Name: Daniel Fitzsimmons

clinic address: 4464 Central Ave. East Suite

Saint Petersburg, FL 33711

clinic phone number: 7274226945

email address: sanctuarydr@yahoo.com

Website: www.sanctuaryacupuncture.com

Last modified: September 8, 2009  Tags: , , , ,  В·  Posted in: EENT, Neurological, Well-Being