12 Oct Acupuncture for Migraines: A Case Study
A case study on the treatment of migraines using Acupuncture and cupping therapy
The Case
A 30 year old male presented to the clinic with chronic severe migraines, the migraine episodes were occurring 3-4 times per month, for several years. The migraines included visual aura, severe throbbing headaches, nausea, vomiting, photophobia, and fatigue The migraines were often over the weekend, after his working week. The patient felt that the migraines were worse with stress and alcohol, and he had tried various modalities including physiotherapy, some of which had helped to reduce some symptoms.
He was otherwise fit and well. The migraines were having a significant impact on his life and functioning. After a thorough TCM consultation, including a pulse and tongue analysis, the patient was diagnosed with Liver Qi Stagnation and Liver Yang Rising.
The aim of the treatment was to encourage the smooth flow of Liver Qi in the body, reduce stress and loosen muscle tension.
Treatment
Treatments were performed weekly for 6 weeks, then fortnightly for 6 weeks and then monthly as maintenance.
The initial treatment included these Acupuncture points: GB20, GB21, LIV3, LI4, BL18, BL19, DU20, DU24, GB34, retained for 20 minutes. As well as fire cupping of the upper and mid back for 7 minutes.
After the first two treatments the patient reported a reduction in migraine severity.
The following treatment included these Acupuncture points: Tai Yang, Yin Tang, DU24, CV17, LIV2, LI4, LIV14, CV6, GB34 retained for 20 minutes, As well as fire cupping of the upper and mid back for 7 minutes.
The patient began to experience a reduction in severity and frequency of migraines, and after 2 months of treatment was experiencing 1 migraine per month, followed by a total reduction of migraines after 3 months.
The Liver organ system in Traditional Chinese Medicine is responsible for the smooth movement of Qi in the body, with the smooth movement of Qi there is smooth movement of blood and nutrients in the body. Too much stress, frustration, and improper lifestyle over a long period of time causes the Liver Qi to stagnate causing stagnation of Qi and Blood, affecting the head. This stagnation creates excess Yang which rises to the head, causing headaches. This stagnation of the Liver contributes to Yin deficiency, in the body, further exaggerating the Liver Yang rising to the head. Stress and frustration stagnates the Liver Qi, conversely, frustration is a sign of a stagnant liver. Liver Qi can rise upwards causing the rising of Liver Yang, which agitates the head. there is often a feeling of pressure over the Liver and over the chest, and a feeling of something stuck in the throat, as well as neck tension, tight muscles generally.
Western understanding
Migraines are a neurological disfunction that involves nerve pathways and chemicals. Changes in the brain affect blood in the brain and surrounding tissues, causing a range of symptoms. Pain, nausea, photophobia, dizziness, fatigue. Can last for several hours to several days.
Can be in 4 phases:
Prodrome phase; pre-headache, mood swings, stiffness, food cravings Aura phase: sensory disturbances before a migraine, blurred vision, blind spots, numbest , speech issues.
Headache phase: pain hits, nausea, sensitivity.
Postdromal phase: pain subsided, confusion, fatigue, feeling unwell.
Other Causes:
- Gender, hormones (more common in women)
- Allergies
- Improper diet
- Stress and anger
- Family history; genetics
- Environmental
Headache and migraine vary depending on which organ system is involved. Location and type of pain, causing factors, times day, are part of the diagnostic criteria.
How does Acupuncture help migraines?
- Rebalance the organ systems
- Increase relaxation
- Reduce tightness in the neck
- Stimulate the release of endorphins
- Promote circulation of blood and qi
The Research
Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multi-centre, randomised clinical trial
https://www.bmj.com/content/368/bmj.m697 Xu, S et. al. March 2020
150 study participants
To assess the efficacy of manual Acupuncture as a treatment for patients with episodic migraine without aura
Seven hospitals in China June 2016 to November 2018 20 sessions of manual acupuncture plus usual care 20 sessions of non penetrating sham acupuncture at non acupuncture points plus usual care or usual care alone over 8 weeks
Mean age 36.5 years 82% women
“A recent study from March 2020 conducted by Xu, S et. al. showed that Acupuncture provided patients with a significant reduction in migraine headaches over an 8 week trial period. The group receiving Acupuncture (plus usual care) was compared to a group receiving “sham Acupuncture” (plus usual care), and a group receiving usual care alone. Sham Acupuncture refers to non-penetrating Acupuncture at non Acupuncture points on the body.
The participants all suffered with episodic migraines (without aura). The participants were mostly women with an average age of 36 years, who all received 20 sessions of Acupuncture. The study showed that the Acupuncture group experienced a significant reduction in migraine days at weeks 13 to 20 by a reduction of 3.5 days compared to the sham Acupuncture group at a 2.4 day reduction. Also a significant reduction in migraine attacks at week 17 to 20 reduced by 2.3 attacks compared to a reduction of 1.6 attacks in the sham group. The Acupuncturists in the study applied the treatment based on the individual’s Traditional Chinese Medicine diagnosis, meridian and organ system involvement, much like your Acupuncturist would do in a typical treatment. This is because symptoms can have unique causes in different people. This study demonstrates the effectiveness of Acupuncture in the treatment of Migraine headaches (without aura), and can be considered a safe and effective treatment for those suffering with migraines who find drugs ineffective or are hesitant to use prophylactic drugs.”
