Acupuncture Treatment for Headache (头痛)

Table of contents
  1. The Introduction of Headache
  2. Etiology and Pathology
  3. How to Diagnose and differentiate Headache
  4. The Treatment of Headache
  5. Suggestions and Comments

The Introduction of Headache


This is pain of the head associated with various intracranial or extracranial factors. It is a very common symptom of numerous diseases. It is called Tou Tong (“Headache”), Tou Feng (“Head Wind”), or Nao Feng (“Brain Wind”) in TCM (Etiology and pathology of headache).

Western medical classifications

Headache may be categorized into tension headache, vascular (cluster, migraine), and inflammatory headache. It may also be classified into functional headache and organic headache. Functional headache has no clear cause; for instance, migraine or headache during menstruation. Organic headache is usually caused by inflammation or pressure on the meninges, cerebral blood vessels, or cranial nerves; for example, headache due to meningitis, hypertension, trigeminal neuralgia, or an intracranial space-occupying lesion.

Etiology and pathology of headache
Etiology and pathology of headache


Corresponding diseases in CWM

  • Hypertension.
  • Sinus problems (if frontal headache).
  • Neurosis.
  • Brain trauma (concussion → blood stasis).
  • Infection (especially with high fever).
  • Meningitis, tumor.
  • Trigeminal neuralgia.
  • Eye problems (e.g. glaucoma).

Etiology and Pathology


  • Invasion of EPFs:
    • Wind-Cold invasion (especially in winter and spring) congeals collaterals, leading to blockage of meridians and collaterals.
    • Wind-Heat or Wind-Damp from living conditions or Warm Diseases disturbs or blocks the clear orifices.



  • Emotional stress leads to Liver-Qi stagnation, which could turn into Fire and damage Liver Kidney-Yin → Liver-Yang rising → disturbs the clear orifices → headache.


  • Weak constitution, Essence deficiency → Blood deficiency → Marrow deficiency fails to nourish the Brain.
  • Liver-Yin and Kidney-Yin deficiency → Yang rising disturbs the clear orifices.
  • Jing deficiency → deficiency of Yin leads to deficiency of Yang → clear Yang fails to ascend to warm and nourish the Brain.


  • Improper diet, overstrain, or long-term illness weakens the Spleen → failure to produce Blood and Qi → headache.
  • Spleen deficiency (Phlegm-Damp blocks ascending and descending of Qi and Blood).

(4)Blood stasis

  • Mostly from head injury (car accident, fall).
  • Chronic disease will eventually affect collaterals, causing Blood stasis.

(5)Etiopathology summary

  • There are two categories of headache — exogenous and endogenous.
  • Wind and Fire (internal or external) are the most frequent pathogens.
  • Exogenous headache is usually induced by Wind but often combines with Cold, Heat, or Damp.
  • Endogenous headache is mainly related to Liver, Spleen, Kidney, and Blood stasis.

How to Diagnose and differentiate Headache

(see Table 24)
Tips for differentiation

(1)Differentiating between acute and chronic


  • Mostly caused by EPFs.
  • The majority are severe headaches.
  • Burning, contracting, throbbing, distending, or heavy kind of pain.
  • Pain is consistent.


  • Mostly endogenous disorders.
  • Dull or hollow pain with dizziness.
  • Aggravated by overwork.
  • Pain is intermittent.

Exception: Blood stasis can be chronic and is characterized by fixed, severe, and stabbing pain.

(2)Differentiating between excess and deficiency


  • Exogenous headache is caused by Wind, Damp, Cold, or Heat.
  • Endogenous headache includes Liver-Fire headache.


  • Usually affects people with a weak constitution.
  • Liver-Yin or Kidney-Yin deficiency.
  • Kidney-Essence deficiency.

Table 24.Differentiation and treatment of headache

Table 24.Differentiation and treatment of headache
Table 24.Differentiation and treatment of headache


  • Headaches due to turbid Phlegm and Blood stasis usually have the nature of root deficiency with branch excess.

(3)Differentiating the locations

  • Taiyang headache — occipital headache that refers to the neck.
  • Yangming headache — frontal headache that refers to the eye socket.
  • Shaoyang headache — temple headache that refers to the ear.
  • Jueyin headache — vertex headache that may refer to the eye socket.
  • GV Meridian headache — vertex headache.
  • Shaoyin headache — pain deep inside the head.

The Treatment of Headache

Principle of treatment

(1)Acute (usually excess)

  • Remove pathogenic Qi.
  • Disperse Wind, plus:
    • Dispel Cold.
    • Clear Heat.
    • Remove Damp.

(2)Chronic (usually deficiency)

  • Tonify Zheng Qi through nourishing Liver-Yin and Kidney-Yin, or tonify Yin and Blood.


  • Tonify plus reduce.


(1)Basic points

  • GB 20 and GV 20, Taiyang, LI 4, LU 7, SI 3, Ashi points.

(2)Exogenous headache

  • The three Yang meridians yield the main points.
  • Reducing method and moxa for the Wind-Cold pattern.

(3)Turbid phlegm

  • CV and ST Meridians as the main points.
  • Reducing method.
  • Nausea → PC 6.

(4)Blood stasis

  • LI, ST, SP, and Ashi points as the main points.
  • Tonifying plus reducing method.

(5)Liver-Yang rising

  • LR and GB as the main points.
  • Reducing method.
  • May also tonify Foot Shaoyin.

(6)Kidney deficiency

  • Kidney Meridian and Back Shu points as the main points.
  • Tonifying method.

(7)Yin and blood deficiency

  • GV, ST, SP Meridians and Back Shu points as the main points.
  • Use the tonifying method, and combine it with moxa.

(8)Modification based on location

Frontal headache:

  • GV 23, 24
  • GB 14
  • BL 2
  • ST 8, 41, 44
  • Yintang
  • LI 4

Temple headache:

  • GB 4, 8, 41
  • TE 20, 5

Occipital headache:

  • GV 17
  • BL 9, 10, 62, 65
  • SI 3

Vertex headache:

  • GV 20
  • LR 3
  • Sishencong

Shaoyin headache:

  • KI 1
  • GV 20
  • KI 3

Auricular acupuncture

  • Occipital
  • Forehead
  • Temple
  • Brain
  • Shenmen
  • Liver
  • Subcortex
  • Stomach
  • Gall Bladder
  • Urinary bladder

Three or four points each time; retain for 20–30 min or apply ear seeds. Bleed veins on the back of the ear or the ear apex for severe headache.

Plum blossom needle

Best for exogenous headache, as well as headaches due to Liver-Yang rising or Blood stasis.

  • Taiyang
  • Yintang
  • Ashi points

Apply cupping after tapping with the plum blossom needle

Magnetic therapy

  • ST 8
  • Taiyang
  • GB 20
  • Anmian
  • Ashi points

Two to four points each time. Change the magnetic beads every two days.


  • Sensory area, upper 1/5.
  • Blood vessel dilation and contraction area, upper 1/2.

Electrostimulation for 15–20 min.


  • Choose one or two pairs of points, including one or two local points and one distal point on the limbs.
  • Use continuous wave and mild stimulation for 20 min.

Suggestions and Comments

  • Acupuncture works quite well on headache, but a complicated headache that does not respond to acupuncture may be due to an intracranial disorder such as a tumor.
  • Headache that is accompanied by uneven pupil sizes plus stiff neck and loss of consciousness usually indicates cerebral hemorrhage (stroke) with high intracranial pressure; This is a medical emergency, so call 911.
  • For hypertension headache, be careful when using strong stimulation and electrostimulation.
  • Combine Qigong, Tuina, and massage for complicated cases.
  • Regulate the diet. Avoid food allergies, eat more vegetables, avoid eating too much of animal products.
  • Regulate emotions, cope with stress, and avoid overwork.
  • Quit smoking and avoid overconsumption of alcohol.
  • Try to get fresh air, especially in winter.
  • Massage the neck muscles or use a heat pad to improve the local circulation.
  • For the whole head, especially in the case of distending headache, use only distal points; if the headache is severe but localized, use local points; it is generally best to combine local and distal points.