Acupuncture management for a migraine
Migraine is one of the most common forms of a disabling headache. It affects around 12% of the general population and accounts for 15% of primary headaches. It is a chronic recurrent disorder with intense, episodic, unilateral throbbing headache affecting the temple, forehead, or eye and may spread to the whole head. It is worsened by movements and daily activities, last from 4-72 hours and is associated with nauseas, vomiting, photo-sensitivity, and phono-sensitvity.
Epidemiological studies have documented the high prevalence, socio-economic, and personal impact of migraine which is now ranked as number 19 among all diseases world wide causing disability according to the world health organisation.
Western medicine on migraines
The pathway of pain in migraine is not completely understood although 3 major theories are postulated
1. Vascular theory- vasodilation (widening of blood vessels) of the temporal arteries.
2. The neurological theory- abnormal neural firing and neurotransmitter release in the brain.
3. The current neurogenic theory regards the release of inflammatory neuropeptides from the trigeminal (a nerve) sensory fibres with consequent inflammation of meningeal vessels surrounding the brain, to be a major step of migraine pain.
Diagnosis of a migraine
The international classification of headache disorders set out by the international headache society divides the diagnosis into two major sub types; Migraine without aura is the most common subtype with a higher average attack frequency that is usually more disabling and often with menstrual relationship.
Conventional treatment of a migraine
A migraine can often be well managed by a combination of preventative measures. Acute treatment focuses on stopping the attack from progressing and limiting pain and such as nurofen, aspirin, and serotonin receptor activators; ergots and triptans, which are the anti migraine gold standard. The goals of preventative treatment are to reduce the severity, frequency or duration of attacks an prevent the development of chronic daily headaches. Currently the major classes of preventative drugs include the anti-depressant amitritpyline, and beta block propranolol.
Chinese medicine view on migraines
In traditional Chinese medicine and acupuncture migraines are categorised as a symptom of head wind. Wind in Chinese medicine is closely associated with the liver and occurs due to the failure of Qi (energy) not moving. Headaches are often associated with the liver meridian as it ascends to the head. Wind can generally affects the top part of the body, and can have a sudden onset thus affecting the liver meridian. Causing sudden episodes of violent pain around the temple and can often cause visual disturbances. The eye is also very closely associated with the liver meridian. If you think of this in terms of the weather; wind can have sudden gust and then stop.
Acupuncture points and treatment principles of Chinese medicine
According to Acupuncture and Chinese medicine theory, treatment for acute migraine-headaches should concentrate on moving Qi (energy), as a stagnation of Qi or blockage results in pain. Local points according to where the pain is along with distal acupuncture points to open the affected meridian, to promote Qi circulation, clear heat and wind.
If you suffer from migraines try using acupressure, or massage these points gently!!!
Local points such as GB-20 , Tai yang, DU-20
Research into acupuncture treatment of migraines.
Vickers et al., (2004) randomized 401 primary care patients with chronic, headaches, predominately migraine to receive either individualised acupuncture or usual care for 3 months. At the primary end point (12 months) headache scores were better in patients randomized with acupuncture. The patients used 15% less medication and made 25% fewer visits to the GP and 15% few days off sick.
A recent cochrane review concluded that acupuncture is effective in treating acupuncture, and is possibly more effective that drug treatment for migraine prevention, and has no adverse effects, and should be considered as a treatment option for patients willing to use it. One theory as to why acupuncture works is via endophins (feel good hormones) or limbic-touch response.
Migraine is a disease with repeated attacks that is difficult to cure with routine medications. However acupuncture is individualised for the patient according to pattern diagnosis. Thus working on the root and symptoms creating the best cure, or at least long-lasting remission. There is strong evidence for the use of acupuncture management of migraines which should be considered as an alternative of adjunctive to conventional treatment of migraine sufferers.