The Patterns of Migraine and Tension Headaches - what do your symptoms say about you?

A "pattern" in Traditional Chinese Medicine can be akin to a diagnosis in Western medicine. That said, a headache can be a diagnosis in Western medicine, whereas it is merely a symptom in TCM. Patterns take all the symptoms into account. They are a summation of symptoms, if you will. This can make them different from diagnoses from a biomedical standpoint.

For example, there is no pattern by the name of “migraines”, but there is a diagnosis of migraines. The pattern of that migraine may, instead, be “Stagnation of Cold in the Liver channel”.

While it may sound insane and confusing, it’s not to an acupuncturist. Just as MDs use diagnoses as guidelines to test and treat properly, acupuncturists use patterns as guidelines to test and treat properly. Whether the language makes sense to you or not, it does to someone else who can use their education and experience to simplify it.

To me, the word “pattern” sounds much less intimidating than “diagnosis”.



Quick Pattern Guide here, much more detail below:

  • Migraine Headaches

    • Liver Qi Stagnation with Blood Stagnation

    • Stagnation of Cold in Liver Channel

    • Wind Attack (Cold or Heat)

  • Migraine or Tension Headaches

    • Kidney Essence Deficiency (Yin or Yang)

    • Liver Yang Rising

    • Liver Fire

    • Phlegm Obstruction

    • Blood Deficiency - Liver or Heart

  • Tension Headaches

    • Liver Qi Stagnation

    • Spleen Qi Deficiency with Dampness

    • Qi and Blood Deficiency

TCM Pattern
Liver Qi Stagnation with Blood Stagnation[4]

Features
Stabbing, "boring", splitting, fixed location

+ worse at night

+ dark complexion

+ rib or abdominal pain

+ painful periods with clotted blood

T: pink/purple, or red/purple[4]

P: wiry or choppy

Treatment Principles
Move Blood and Eliminate stasis

Move Qi

Open the upper orifices[4]

Acupuncture
Sp6, LI4, Sp10, ST36, UB17, Du20

Herbal Formula
Xue Fu Zhu Yu Tang - Drive out Stasis in the Mansion of Blood Decoction[4,7]

Notes
Tend to be chronic or caused by trauma[4]


TCM Pattern
Stagnation of Cold in Liver Channel[3]

Features
Dull but intense

+ feeling of cold in the body

+ vomiting

T: pale, wet, white coat

P: wiry, slow

Treatment Principles
Dispel Cold

Unblock the channels

Descend Rebellious Qi

Harmonize the Middle Jiao

Acupuncture
Ren4, Ren6, Ren12, Du20, Liv3, PC6

Herbal Formula
Wu Zhu Yu Tang - Evodia Decoction[6]

Notes
May occur all over the head


TCM Pattern
Wind Attack (Cold or Heat)[4]

Features
Headache with acute onset, stiff feeling

+ fever, chills

+ nasal congestion

+ body aches

+ dizziness

Treatment Principles
Dispel Wind

Remove obstruction in the meridians and collaterals

Regulate the Qi and Blood

Acupuncture Base points
Wind-Cold: Du16, UB12, GB20, LU7, LI4

Wind-Heat: Du14, LI11, LI4, SJ5, LU10, LU11


Add any of the following point combinations based on location of the headache
[5]
Occipital: GB20, UB60, SI3

Frontal: ST8, Du23, Du24, LI4, ST44

Temporal: Taiyang, GB8, SJ5, GB41

Parietal: Du20, SI3, UB67, LV3

Herbal Formula
Chuan Xiong Cha Tiao San - Ligusticum Chuanxiong Powder to Be Taken with Green Tea[7]

Notes
May be accompanied by symptoms of an upper respiratory infection, or the Wind has been able to penetrate someone with a longstanding underlying deficiency and can do so in a chronic manner.

The rest is on Substack.

With this complex world that we live in, patients often have multiple patterns that contribute to their signs and symptoms. This is why it’s best to speak with someone who can dissect all the complexities for you.

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