Acupuncture for Headaches - Treatment Protocols

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for headaches and related conditions such as migraines. There are many ways to treat this condition with Eastern Medicine and our presentation is only one of many possible options.

Headaches may be diagnosed generally by looking at the nature of the pain, what makes the pain better or worse and the location of the pain. If the pain is dull it is likely from deficiency, whereas sharp pain is likely from excess. If the pain is better with rest it is likely from deficiency, whereas if it is improved with movement it is likely from stagnation. Locating which channels are near the pain, ST, GB, etc. will also aid in the selection of proper treatment points.

  • Etiology & Pathology:
    • Differentiation:
    • Wind Cold - Excess
      • Signs & Symptoms:
        • Distending/pulling sensation in the head, may be tight in the posterior aspect of the head, common wind cold symptoms such as chills, stuffy nose a/or body aches, may arise due to allergies in the spring or during the change of seasons.
        • Tongue:  Thin white coat
        • Pulse:  Floating, tight
      • Treatment Points:
        • Valaskatagis Point Selection:
        • GB 20 - clear wind
        • GV 16 - clear wind
        • UB 12 - wind shu
        • LU 7 - clear wind, command point of head and posterior neck
        • Consider cupping for to release wind cold
        • Consider locational points as described above
        • St. John Point Selection:
        • Same as above plus:
        • LI 4 - release exterior wind/wind-cold
        • UB 10 - release the exterior for wind cold
    • Wind Heat - Excess
      • Signs & Symptoms:
        • Distending or "splitting" headache, heat signs such as red face a/or eyes, fever, thirst.
        • Tongue:  Red, possibly w/thin yellow coat
        • Pulse:  Floating, fast
      • Treatment Points:
        • Valaskatagis Point Selection:
        • LI 4 - clear heat, release exterior
        • LI 11 - clear heat
        • GV 14 - release the exterior, clear heat
        • Consider locational points as described above
        • St. John Point Selection:
        • Same as above plus:
        • GB 20 - clear wind from head
        • GV 16 - clear wind from head
        • TH 5 - release the exterior, clear the head
    • Wind Damp - Excess
      • Signs & Symptoms:
        • Sensation of a "towel wrapped around the head", heavy body, poor appetite, may have chest oppression
        • Tongue:  Greasy coat
        • Pulse:  Soft, slippery
      • Treatment Points:
    • LV Yang Rising - Excess Internal
      • Signs & Symptoms:
        • Severe headache usually worse in the afternoon, may be pulsing a/or accompanied by the appearance of blue veins on the forehead or temples, headache is usually bilateral although it may be one sided, pain may worsen if lying down, patient may have a quick temper, irritability, bitter taste in the mouth, red face, constipation. May also effect the ST leading to nausea a/or vomiting.
        • Tongue:  Red w/thin yellow coat
        • Pulse:  Wiry and rapid or forceful
      • Treatment Points:
        • Valaskatagis & St. John Point Selection:
        • LV 3 - resolve LV stagnation
        • SP 6 - tonify the yin
        • KD 3 - tonify the yin
        • GB 4 - headache
        • GB 20 - descend the Qi from the head
        • GB 43 - clear heat from the GB channel
        • Taiyang - headache
        • If ST involvement - PC 6, GB 34, CV 12 a/or ST 36
    • LV Fire - Excess Internal
      • Signs & Symptoms:
        • Further progression of LV Yang Rising but with a worse headache and stronger heat signs, red face, strong anger, possibly shouting.
        • Tongue:  Red w/yellow coat, red sides possible
        • Pulse:  Wiry and rapid or forceful
      • Treatment Points:
        • St. John Point Selection:
        • LV 2 - clear LV fire
        • SP 6 - tonify yin
        • GB 20 - descend the Qi from the head
        • Taiyang - headache
        • For strong emotional involvements - PC 8
    • Phlegm Turbidity - Excess Internal
      • Signs & Symptoms:
        • Headache with strong sensation of heaviness, pain is worse in damp weather, may experience dizziness, may also have other phlegm signs such as fullness in the chest a/or epigastric area, nausea, vomiting of watery mucus.
        • Tongue:  Greasy white coat
        • Pulse:  Slippery
      • Treatment Points:
    • Blood Stagnation - Excess Internal
      • Signs & Symptoms:
        • Usually the result of a trauma, headache that is fixed in location with very strong a/or drilling-type pain, may be worse at night.
        • Tongue:  Purple possible w/purple a/or dark red spots
        • Pulse:  Choppy or wiry
      • Treatment Points:
    • Qi Deficiency - Deficient Internal
      • Signs & Symptoms:
        • Headache that is consistient and dull, may involve the whole head or the frontal area, worsens with overwork or other mental a/or physical stressors, poor appetite and fatigue.
        • Tongue:  Pale w/thin white coat
        • Pulse:  Weak
      • Treatment Points:
        • St. John Point Selection:
        • SP 6 - tonify ST/SP
        • ST 36 - tonify ST/SP
        • CV 6 - tonify Qi
        • GV 20 - raise the Qi to the head
        • UB 20 - SP Shu
        • Consider locational points as described above
    • Blood Deficiency - Deficient Internal
      • Signs & Symptoms:
        • Headache that worsens with exertion, improves with rest, pain may be dull in nature with an empty feeling in the head, palpitations, insomnia, poor memory, pale complexion, dry skin possible, in women this type of headache may be worse after their period.
        • Tongue:  Pale
        • Pulse:  Thin, weak
      • Treatment Points:
    • Kidney Deficiency - Deficient Internal
      • Signs & Symptoms:
        • Empty feeling in head, weak low back a/or knees, fatigue.
        • Tongue:  Pale (if more Yang def), Red w/little coat (if more Yin def)
        • Pulse:  Deep, empty, may be thready if more Yin def)
      • Treatment Points:

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

  • St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
  • Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes