Treating headaches and migraines with medical acupuncture

If you've never had a headache, I'd be surprised to hear it. Headaches and migraines are among the most debilitating, painful conditions–and they're among the most common. There are many causes, types, and treatments. If you're someone who suffers from frequent headaches, it can be very frustrating to try to figure out how to deal with them. Prescriptions and over-the-counter medications as well as invasive procedures such as Botox are often recommended and, increasingly, so is acupuncture.

Tension headaches are a frequent reason that people come to our clinic. They can be caused by stress and spasms of the muscles of the head, face, and neck. Acupuncture excels at encouraging tight muscles to release and relax by stimulating trigger points that control those muscles, and helping redirect circulation that may be causing a sensation of pressure around the head. A tight and painful neck can often refer pain up into the temples, forehead, and around the eye. Temporomandibular Joint Syndrome (aka TMJ) is a dysfunction of the jaw muscles that can also spread pain to those areas. In my experience, acupuncture is one of the best modalities for restoring proper function and flexibility to these tissues, relieving these types of headaches.

Acupuncture also signals your body to release endogenous (naturally occurring within) pain relieving chemicals, which can help with specific and widespread body pain. Recent studies have found that "adenosine triphosphate (ATP) and transient receptor potential vanilloid (TRPV) channels are involved in the stimulation of acupuncture at the acupoint area. In the central nervous system (CNS), neurotransmissions including opioids, serotonin, norepinephrine, orexin and endocannabinoid are modulated by acupuncture to induce analgesia" (American Journal of Translational Research, 2022).

Cluster headaches are another type that can cause excruciating pain in the eye area. They often flare up in rapid succession in a short period of time, hence the "cluster" moniker. Their exact cause is unknown, but Johns Hopkins Medicine explains that a sudden flood of histamine to the area may be a contributing factor. Acupuncture has been shown in multiple studies to facilitate reduction in the body's histamine response, making it a great option for prevention and treatment of this kind of headache.

A 2022 paper published in Frontiers of Neuroscience states that "acupuncture may have the potential to inhibit neuronal activity caused by neuropathic pain, through reducing the activation of pain-related ion channels and suppressing glial cells (including microglia and astrocytes) to release inflammatory cytokines, chemokines, amongst others."

Inflammation or irritation of the trigeminal nerve may be another cause of recurrent headaches, which is one of the cranial nerves that innervates much of the face. Viral infections can lead to nerve dysfunction such as Bell's Palsy and herpetic neuralgia; seasonal allergies can cause inflammation in the sinuses, which can cause headaches in the forehead and temples. Since acupuncture can help reduce inflammation and regulate your body's immune response, it's a great option for headaches that may be influenced by these causes.

Migraines are a recurrent type of head pain that can be severe and disruptive. It's estimated that 12% of the population gets migraines, with women likely to suffer from them three times as often as men. Often characterized as throbbing and on one side of the head, they can be accompanied by nausea and indigestion, and vision disturbances such as photophobia, where bright lights become intolerable, or what's called an "aura," where you may see halos around objects or just have a general sense of foreboding, as if you can sense the migraine before it comes on. Migraines also often have a "prodrome," which is a period of fatigue, mental depression, and malaise for a day or two after an episode.

Migraines are also thought to be caused by dysfunction of nerves and blood vessels in the head, and may be influenced by genetics. A rare form of migraine, called hemiplegic migraine, can present with paralysis and pain on one side of the body. Migraines can have many triggers, from fatigue or stress to hormone imbalances. Some people are triggered by changes in weather and barometric pressure, or other environmental influences such as smoke or perfume.

The Canadian Medical Journal Association published a synopsis of acupuncture's efficacy for prevention and treatment of migraines in 2012. This article describes a 2009 Cochrane review of more than 20 high-quality trials with 4419 subjects, concluding that "there is consistent evidence that acupuncture is beneficial in the treatment of acute migraine attacks, and that the available studies suggest that acupuncture is at least as effective as prophylactic drug treatment and has fewer adverse effects."

Menstrual-related headaches are thought to be caused by the drop in progesterone and estrogen levels associated with the start of the menstrual cycle. A 2018 literature review by Evidence Based Complementary Alternative Medicine analyzed 23 articles from Pubmed, EMBASE, and Cochrane Database that explored acupuncture's influence on sex hormones. The studies showed that acupuncture increases estrogen, especially estradiol, progesterone, prolactin, and other hormones. This could explain why many of our patients report a reduction in severity and frequency of these symptoms after a course of acupuncture.

If you suffer from headaches or migraines and feel like you've exhausted your treatment options, it's time to try acupuncture! As an adjunct therapy or a first approach, the evidence increasingly backs acupuncture as an effective, safe modality to help get the relief you deserve.