Migraine

Key Points

First, what cannot wait

Understanding the Condition

Migraine is not "a worse ordinary headache" — it is a distinct neurological condition. Think of a misfired power grid in the brain: blood vessels and nerves fall out of sync, producing a pounding, often one-sided pain.

In plain words: an ordinary headache is like muscle soreness; a migraine is like a blackout restart — during an attack, most people simply cannot function and retreat to a dark, quiet room.

Why It Keeps Coming Back

Because triggers are scattered across daily life: irregular sleep, skipped meals, bright light, weather changes, hormonal shifts, specific foods… Enduring it or popping painkillers only presses pause.

Frequent painkiller use can also cause medication-overuse headache — pain that gets worse the more you treat it. That is one common reason migraine feels increasingly stubborn.

Our Pattern-Based Approach

TCM reads migraine not as "a painful spot" but as "a pattern of imbalance." Common patterns: liver yang rising — a throbbing pain that flares with anger; liver qi stagnation turning to fire — distending pain after long-suppressed emotions; phlegm-dampness disturbing upward — a heavy, wrapped feeling with nausea.

Acupuncture aims to guide the "rushing qi" back down: points along the shaoyang and jueyin channels, plus individualized tuina and lifestyle adjustment. For frequent sufferers, we focus on the interval between attacks — not just firefighting on painful days.

Common patterns and treatment directions

Patterns are determined in person. This list is for orientation only and is not a self-diagnosis tool.

The Evidence

• An individual-patient-data meta-analysis of ~18,000 participants (Vickers et al., 2012) found acupuncture significantly superior to sham acupuncture and usual care for chronic pain, including migraine.
  — Vickers et al., 2012, Archives of Internal Medicine (now JAMA Internal Medicine)
• A 2016 Cochrane systematic review found acupuncture at least as effective as prophylactic drugs for migraine prevention, with fewer side effects.
  — Cochrane Database of Systematic Reviews, 2016
• The WHO indication list for acupuncture includes preventive treatment of migraine.
  — WHO, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials

What to expect: first visit to follow-up

1. First visit · about 40 minutesBring your headache diary and prior tests. We take a full history, read the pulse and tongue, and establish a pattern diagnosis — first checking whether yours is a case suited to acupuncture and herbal care. If red flags appear, we will advise referral first.
2. Plan discussion · same dayWe explain the working pattern diagnosis, planned points and treatment frequency, when the first review will happen, and which situations should be managed jointly with a neurologist.
3. Weeks 1-4One to two sessions per week, focused on reducing attack frequency and intensity. You keep logging your headache diary at home.
4. Week 4-8 · first reviewDiary data before and after treatment guides whether we continue, adjust point selection, or move to a longer maintenance interval.

Course of care and follow-up

• Assessment usually runs in 4-8 week cycles (matching the course lengths used in the Cochrane trials)
• Once attacks clearly decrease, care may shift to maintenance every 2-4 weeks
• Pattern diagnosis is re-assessed yearly or whenever symptoms change — patterns shift with constitution, age and season
• We work alongside your neurologist throughout: never stop or reduce prescribed medication on your own

When to Seek Care

Before your visit:

• Keep a headache diary (timing, triggers, sleep, diet)
• Regular routine; avoid skipped meals and late nights
• Use painkillers under medical guidance, and watch frequency

Consider an in-person consultation if:

• ≥4 attacks per month, or increasingly frequent painkiller use
• Changing pattern: more aura, altered pain character
• Persistent neurological signs (slurred speech, limb weakness) — seek emergency care immediately

Supportive Care

• Sleep regularity: a fixed wake-up time beats a fixed bedtime
• Diet: note common triggers (aged cheese, red wine, processed meat, MSG) and avoid them individually
• Emotions: for irritability-triggered attacks, the goal is "coursing", not "suppressing"
• Adjust routine ahead of seasonal transitions to buffer barometric swings

FAQ

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Prepared by licensed TCM physicians · Updated 2026-09

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