Headaches/Migraines

According to Eastern Medicine thought, there are many paths up a mountain. In this article we will be discussing headaches and how both Eastern and Western medicine view headaches. The Western (aka Biomedical) approach is reductionist and relies on empirical observation and symptom differential. The Eastern approach is dynamic, holistic, personalized and also relies on a symptom differential. However, that process looks quite different from the conventional approach. Here we discuss both approaches and how they differ.

How does a Western Medicine Clinician View, Evaluate and Treat Headaches?

According to conventional western medicine, a headache is quite simply defined as the experience of pain in the upper neck, head or face. According to Western Medicine, the most common types of headaches are vascular (think migraines), or involve muscle tension and stress.

Primary and Secondary Type Headaches

According to the Mayo Clinic, there are two classifications of headaches, primary and secondary. In primary headaches, there is no identifiable underlying disease process that is the cause. Primary headaches are most common and are categorized as migraines, migraines with aura, tension and cluster headaches. Here we will briefly discuss the two most common primary headaches, tension and migraine.

Primary headaches are mainly due to lifestyle factors that trigger the headache. Examples include stressful events, poor sleep, poor posture, specific foods, skipping meals, alcohol, hormonal fluctuations, certain smells or bright lights.

Tension headaches are the most common type of headache. These account for 90% of all headaches and are usually felt on both sides of the head and can affect the eyes, scalp, neck as well as the head. Tension headaches are most commonly caused by chronic stress or a stressful event.

Secondary headaches are caused by an underlying disease process or illness. The list of causes is extensive but includes such things as sinus infections, influenza, infections, dental problems, glaucoma, hangovers, etc….

A Western doctor will classify your headache as primary or secondary by assessing your symptoms and by doing a medical exam. If necessary, you may need blood tests or an image of the head or neck. However, primary-type headaches are most common and usually do not require more than an in-office exam.

Western Treatment of Headaches

Treatment is determined based on your diagnosis. However, most people with primary headaches will be given over-the-counter pain relievers like Tylenol or NSAIDs like Ibuprofen.
If the headache is a migraine, treatment may include a prescription medication used specifically for migraines. The most likely scenario is that you will leave your clinician’s office with some advice to rest and a prescription of some kind.
How does an Eastern Medicine Doctor View, Evaluate and Treat Headaches?

According to Eastern Medicine Clinicians, a headache is a manifestation of a symptom, in this case pain, caused by an internal imbalance, known as the root cause. Just like in Western medicine where headaches are categorized as primary or secondary, in Eastern thought, the cause is also categorized but in a very different way. The clinician will assess whether the pain is due to an internal imbalance or due to an external influence like an infection.

Most patients who have headaches due to an internal balance will be assessed for the type of imbalance by checking the patient’s pulse, respiratory rate, color and quality of their complexion, their tongue color and coat. The patient will also be asked about the onset, time, location and character of the pain.

Through this lens, the clinician looks for a pattern unique to the individual to assess what type of imbalance is causing the headache. This differentiation establishes whether the person has imbalance from a state of excess or a state of deficiency somewhere in the body. This means the patient may have an accumulation of too much energy stuck in their body or it could mean they are low in energy and need some kind of tonifying treatment to relieve their headache.

Excess headaches include symptoms like sharp or throbbing pain in the temples or behind the eyes, a feeling of cotton or wool inside the head, sharp pain or feeling of heat in the head or face, feelings of nausea or chest oppression. Deficiency headaches are usually dull rather than sharp, involve the whole head, and are relieved by rest or eating.

In a nutshell, the Eastern clinician is looking for patterns unique to the individual. After a pattern has been established, a diagnosis can be made and that is how treatment is decided.
What are your treatment options in Eastern Medicine?

There are several options for treatment in the Eastern Medicine clinician’s toolbox. This may range from nutrition advice, Qi Gong, stretching, stress-reducing techniques, meditation or simple exercises.

The patient’s stress levels and environment will be assessed along with treatment of the underlying internal imbalance. The patient will have their history and current lifestyle considered in context with their symptoms.

The primary tools used inside the Eastern clinician’s office are high-quality traditional botanical medicines, acupuncture or acupressure. In many instances, a simple trip for an acupuncture treatment can eliminate a tension headache or migraine in one session. Other times, it takes a few treatments as the underlying pattern is addressed. Patients will often come in for preventative treatment so that they can remain headache-free.

Author: Jean Donati PA-C, M.Ac, L.Ac. 

Jean Donati is a Nationally Certified Physician Assistant, Licensed Acupuncturist and owner of Jean Donati Acupuncture.  She specializes in Traditional Five Element Acupuncture, and Facial Rejuvenation for physical, mental and emotional concerns.