Migraines

I have a patient, 20 years old, with chronic migraines for 10+ years.  She often has a dull, heavy headache, but 1 or twice a week, she will get a throbbing, painful migraine that is usually helped by heavy duty migraine medications like Imitrex.  Her dull headaches are usually around the eyes, while the migraines can also wrap around the temples and the back of the head.  She also experiences nausea and sometimes vomiting when a really bad migraine occurs.  She has some sinus allergies, and almost always has post nasal drop.  She catches colds quite frequently.  In addition, she has some anxiety and depression.  Her pulse is wiry and slippery.  Her tongue has a slightly purple body with a stomach crack in the middle and a white coat.

I have diagnosed her with LV Qi Stagnation, Blood Stasis, and SP Qi Def with Damp Phlegm.  I have used a combination of the following points: GB14 (during headaches), Tai Yang (during headaches), Yin Tang, LI4, CV12, CV6, ST36, SP6, GB34, SP9, ST40, LV3, ST44 (during front headaches), GB20.  I generally use about 12 to 14 points total per session. I have also advised her to cut cheese and processed foods as much as possible, as she often eats frozen pizza and macaroni and cheese from the box.  Additionally, I have advised her to do deep abdominal breathing to help with relaxation.

I feel that I have approached this case using a very direct technique, drawing from my training in TCM.  However, I am not getting the results that I expected.  Although I've only seen her 5 times, her symptoms have not improved.  In fact, at times, they seem to have worsened.  Her headaches are coming on more frequently, and she has had a few very major migraines during the weeks I've been treating her.  Also, once after she received treatment from me, she went home and experienced a throbbing headache and subsequently had to lie down and take medication.

Am I missing something here?? Suggestions/insights would be greatly appreciated.  Thank you.


Comments

Chad Dupuis's picture

From my experience migraines

From my experience migraines are either structural or vascular (or, of course, a mix of both).  Generally the vascular type respond well to general TCM pattern treatment and dietary/lifestyle change, whereas the structural based need more focal treatment on the upper neck and cervical huatuo points.  From what I can see the points you are using seem appropriate, although, they would not be as appropriate if the problem is more structural.  Below are the main areas that we palpate for pressure pain and treat in most cases.  You should also read through the general tcm acupuncture for headaches section for a few more ideas from a traditional TCM perspective. 

Our treatments utilize tuina, medical qi gong (in the form of tong ren therapy), and acupuncture.  Generally we would start with qi gong and deep tuina massage on the areas noted below with an asterisk, then perform acupuncture on the points listed below and systemic pattern based TCM points, and then finish with deep tuina after the needles have been removed and most likely use cupping in this case on the upper back.

Huatuo area of C1 and C2 **

Taiyang

TH 16 *

LV 3, LI 4, GV 20, GB 20, and at or around the area where the patient experiences the most pain verified also by pressure pain upon palpation (the "ashi" points).

The most important part of the treatment would be the deep tuina around the huatuo area of C1, C2 and out and around TH 16 (the sky window area).  This opens up the circulation to and from the brain and will have an effect on the vascular dimension of migraines as well as improving circulation in the cervical spine which will aid the structural aspect.

We have very good results with migraines, so I hope you can reproduce what we see in our clinic.  Generally the migraines should become less and less frequent and less strong within 7-10 treatments.  They may, of course, need to be seen over a long period of time but something within the 5-12 treatment range should have the frequency and intensity changed significantly.

 

 

 

Feng Mei's picture

my suggestion

dull heavy pain means too much damp energy in her head, or spleen is too weak can not move the wet energy. if she eat birthcontrol pills also can cause headache.

try ear seeds : shenmen, sinus , 0 points, spleen, neck, spine, ub. 3 days change another ear to treatment.

everyday tuina both ears till it became red color them pull ears 20 times can feel pain on the ears.

thank you

regards

Feng Mei

ang67's picture

Thank you for your suggestions

Thank you for your suggestions.  I will try adding the additional tui na and ear seeds.  I will keep you posted on the progress.