Acupuncture for the Treatment of Migraines

Migraines are a far cry from a normal headache. These recurring episodes are characterized by pain that ranges from moderate to severe and are often accompanied by nausea, sinus-related symptoms. Migraine attacks can last from hours to days, and can often be separated into distinct phases that include pre-headaches, episodes of blurred or altered vision, the headache itself and a debilitating period post-headache.

While western medicine treats migraine symptoms with a variety of drugs and attempts to prevent migraines with a combination of lifestyle and diet changes, vitamins, and prescription medications, acupuncture has proven to be an effective tool that both minimizes symptom severity and significantly lowers migraine recurrence.

Understanding Migraines

To call a migraine a recurring headache does a disservice to the millions of people who suffer with this chronic condition. Migraine is a disabling neurological disease that causes throbbing, pulsing headaches that can be unendurable in their severity and that can last from several hours to several days. The official diagnosis of chronic migraine requires having headaches on 15 or more days each month for at least 3 months. The episodes may be felt on one side of the head or both, in the front or back of the skull, behind the eyes or cheekbones. Movement can make the sensation worse, to the point of inducing nausea or vomiting. Migraine sufferers may find light, smells, or noise intolerable, and are frequently kept from engaging in school, work, and social activities by the experience.

Migraines are estimated to affect approximately 14% of the global population. At the same time that they cause significant misery to patients, migraine headaches account for significant economic impacts, with estimated direct costs (including actual medical spending) in the United States of $11 billion a year and another $11 billion in indirect costs in the form of either absenteeism or lowered productivity while working but experiencing symptoms. Migraine pain is so significant that it resulted in tens of thousands of inpatient hospital visits and over $1 billion dollars in inpatient charges in 2012 alone.

In addition to disabling pain, migraines have been linked to emotional disorders, most notably anxiety and depression. Though the link between migraine and mental health is unclear – with some people developing migraines first and others first displaying signs of mood disorders – statistics show that mental health conditions appear more than twice as often in those who also have been diagnosed with migraine.

Western Opinions and Approaches to Migraine

There are almost as many different opinions of what causes migraine as there are ways to experience them. There is significant scientific evidence in support of a genetic link, particularly among those who experience migraines with aura, but there is also data pointing to the impact of environmental triggers such as sunlight, flickering lights, odors, and even barometric pressure. While education about and avoidance of those factors are certainly helpful in reducing the risk of migraine episodes, western medicine has largely adopted a dual approach to the condition: treating the symptoms with a variety of medications, both when they are happening and trying to prevent their return.

When a migraine is occurring, physicians prescribe pain relievers acute approach provides pain relieving medication, using progressively stronger medications as the pain progresses. These can range from first-line therapies such as over-the-counter analgesics and nonsteroidal anti-inflammatory drugs to triptans or intranasal lidocaine. These may provide some relief, but individual responses to specific medications vary. There are some abortive therapies that can work if taken shortly after the migraine begins. Each of these options carries its own risk of adverse reactions and contraindications based on age, medical condition, pregnancy, and other factors. Prophylactic treatment is also available for the management of chronic migraine, but these too must be carefully selected and prescribed based on comorbidities and the potential for side-effects. Many of these treatments have yielded only marginal success.

Traditional Chinese Medicine’s Approach to Migraine

While western medicine takes a biomedical perspective to migraine, its causes, and its treatment, Traditional Chinese medicine takes an entirely different view. Persistent chronic migraines may be classified as internal disorders affecting the channels or meridians of the body. Acute onset migraines are often viewed as external invasions caused by our environment and can be triggered by weather or external environmental stimuli perceived as noxious to the body. East Asian medicine views migraines as disruption and stagnation of the body’s harmonious flow of  energy in the head.

Diagnosis and proper treatment strategy involves inspection of the body for temperature fluctuation, as well as visual inspection of the tongue, the palpatory inspection of the radial pulse, and careful questioning to determine not only the proper identification of the channels causing the issue, but deeper root imbalances that contribute to the predisposition for migraine. Once all this information has been gathered, an appropriate treatment strategy can be initiated.

The World Health Organization has identified headache as one of the conditions for which acupuncture is effective, and various studies support this conclusion. A retrospective analysis of neuroimaging studies on the use of acupuncture in migraine may hold a key to why the approach works so well.  Through Positron Emission Computed Tomography (PET/CT) and functional magnetic resonance imaging, (fMRI), researchers identified a neural mechanism that they theorize may be related to the regulation of pain-related brain networks.

Whatever the biophysical reason, researchers have concluded that acupuncture effectively reduces the symptoms and recurrence of migraine, as well as the medical expenditures related to the condition. One 24-week study involving the use of true acupuncture in 249 patients with migraine without aura found that the protocol significantly reduced the frequency of migraine attacks, while another conducted on 147 patients with migraine without aura “resulted in a significantly higher reduction in the frequency of migraine days and migraine attacks” than that delivered by other treatment methods. Electroacupuncture treatments delivered better overall patient outcomes with regard to duration of pain, frequency of attacks, and Visual Analogue Scale scores, all without the adverse effects and comorbidities presented by western medicine’s drug-based approach.

Sharon Sherman has been licensed to practice acupuncture and Oriental Medicine since 2001, and holds the highest credential available from both the Pennsylvania State Board of Medicine and the National Certification Commission for Acupuncture and Oriental Medicine. Her knowledge and understanding of pain management and the skillful use of acupuncture and Chinese medicine assure patients of the highest level of care and professionalism.