TCM for MigrainesAdina Stanescu, R.TCMP November 1, 2005
Migraine headaches affect 20% of women and 15% of men at some time in their lives, making this a very common condition of modern society.
Several factors distinguish this disorder from the run of the mill headaches that most of us suffer with occasionally:
• neurological disturbance symptoms such as blind spots, flashing lights, tingling, uncoordination preceding the attack
• nausea, vomitting, diarrhea
• hypersensitivity to light (photophobia), sounds (phonophobia), smells (osmophobia)
• intense, often unilateral, throbbing headache
For the purposes of a conventional medical diagnosis of “migraine” at least two of the above factors must be present.
Surprisingly perhaps, one third of sufferers report their first attack before the age of 10. In children however, the abdominal symptoms may take centre stage. There is, in fact a disorder called Cyclical Vomiting Syndrome which occurs primarily in children and it is thought to be a migraine type disorder. Preliminary case reports from Stanford University indicate that acupuncture can greatly lessen the severity and frequency of the vomiting flare ups, which if untreated, can land the child repeatedly in hospital with severe dehydration.
In adults, factors which precipitate the onset of migraine are anxiety, relaxation after stress (weekend migraine), exercise, bright or flashing lights, missing meals, alcohol, the pill, or menstruation.
Traditional Chinese Medicine TCM has an excellent track record at treating this condition, with good results expected in the most stubborn cases. The key to successful treatment is proper diagnosis according to TCM theory, as the underlying causes may vary according to the patient. It should be said that although the treatment of classic “migraine” employs some very specific, very strong herbs, the diagnosis is similar to that made for simple headache.
BLOOD DEFICIENCY TYPE
This is rather common in women, and is often brought about by poor eating habits. In such cases, the diet is sporadic, low in protein and the patient is often running on empty. It is not uncommon for the first meal of the day to be consumed many hours after waking up. Over time, this lifestyle makes the Blood weak, undernourished, and lacking the strength to “travel up to the head.”
To make matters worse, monthly menstruation further depletes the Blood, leading to a chronic and entrenched pattern. Still, as long as the patient is willing to eat, herbal therapy gives very quick results with this type of headache, the easiest of all the types to treat. Herbs with a Blood boosting action such as Angelica (dang gui), White Peony (bai shao), and Ligusticum (chuan xiong), are the backbone of the treatment.
This pattern of migraine is accompanied by poor concentration, a persistent heaviness and fogginess of the head, and tired, heavy limbs. These are all signs of dampness, as all of us might observe on humid, muggy summer days. However, such patients have this dampness inside, and over time it tends to thicken and congeal to become Phlegm.
Phlegm lodges in the meridians and blood vessels, obstructing the Qi and Blood from nourishing the tissues, in this case of the head and brain.
For this pattern of migraine, the herbs used will obviously be very different than the previous type, and in fact were we to use Blood tonics here they would make the condition much worse.
Phlegm-transforming herbs like dried citrus peel (chen pi) and pinellia tuber (ban xia) are needed.
In this pattern, chronic stress and tension over a period of years congest and constrict the Liver energy. Over time, this stagnation heats up and flares upward to the head. There are clear emotional symptoms such as anger, impatience, irritability. Women may suffer from PMS, and migraines may flare just before the period.
The appropriate treatment applies Liver coursing medicinals such as Bupleurum root (chai hu), white peony (bai shao) and uncaria vine (gou teng) to “undo the knots” that make the person so wound up. As well as curing the headaches, one can expect to also be rid of the emotional symptoms.
BLOOD STASIS TYPE
This is the pattern most often found in severe, stubborn, long-term cases. Over many years, any of the above patterns, if enduring and untreated, will begin to obstruct the free flow of Blood in the head. These migraines tend to be sharp, stabbing or boring in character and have a fairly specific, fixed location. Blood Stasis may also show in purplish hue to mouth or face or purplish blood vessels around forehead or temples.
Treatment involves the use of strong Blood moving herbs such as Ligusticum (chuan xion) and peach pit (tao ren).
Improvement in all types of migraine is expected after 3-6 weeks of treatment, while total treatment time may be two to three times longer.
Presently, modern research is beginning to validate some of TCM’s success with this condition. Herbs such as Ligusticum and Angelica are shown to have a strong inhibitory effect against 5HT, neurotransmitters which are linked to migraine headaches.