In western medicine, headaches are subdivided into tension headache, migraine headache, post traumatic headache, cluster headache and cervicogenic headache. In fact, the patient often have different types of the headache simultaneously which is common in clinic; and even after taking many medicines, the headache still could not be effectively controlled. In acupuncture clinic, I often see those patients who want help for their headache even after taking medicines but to no avail. For these cases, I always use a protocol of acupuncture pain management that I have been using for many years in clinical practice. This protocol combined multiple acupuncture techniques through assessment of the Chinese medicine as well as western medical diagnosis includes auricular acupuncture, manual acupuncture, electric acupuncture, active acupuncture and acupuncture in local point or Ashi point.

For example, I had a successful case with a patient who has had 7 years of daily migraine headaches that were over 9 hours long and taken 9 different medicines.

The patient was a 37 year old woman whose husband drove her 1½ hours to come into my office to seek help for her migraine headache and neck pain at 5pm, on a Friday of February in 2016.  She had been very highly recommend by her family friend who had gotten positive result with acupuncture treatment in my clinic. Her chief complaint was migraine headache with neck pain after a car accident in 2009, allergies with nasal congestion for 20 years. She was diagnosed with chronic migraine headache, neck pain, sinusitis, allergies, anxiety and depression. She had histories of sinus and turbinoplasty surgery at 2015, foot surgery on both feet at age 15 & 17.

She had been taking a total of 9 different medicines including celexa for anxiety, zyrtec and flonase for allergies, zanaflex and Mobic for neck pain, axcert and mitrex for headache, and amoxicillin and medrol pack for sinus infection.  But those medicines could not control her conditions. She had a CT scan of the neck with no abnormalities and did injection therapy which was not effective.

Her main symptoms were stiffness with pain in neck and upper back, and the pain radiation to front head, and then severe migraine in front of the head. Her headache was once a day and started regularly at about 2:00AM and lasting until about 12:00PM.  During migraine headache period, she had dizziness, nausea and vomiting, imbalance of body, and accompanied with light sensitivity in her eyes, with her headache getting worse with light. She also had pain with stiffness in her shoulder and arms, tight sensation and ache in her face. She had fatigue, weakness of body, feelings of exhaustion sometimes, stress and anxiety, and poor sleep due to pain. She had nasal congestion, white discharge and postnasal dropped, could not smell, difficulty breathing through the nose, and sometime congestion in the chest. Her neck pain and migraine usually worsen by stress, anxiety, allergies and sinus problem.

Examination showed tenderness and painful sensation at a slight touch or pressure as detailed below. There were painful sensations in her neck at the C2 to C7 at a slight touch, where she placed at 4-6/10 on pain levels. Slight touch to her head on front, sides and occipital was also painful, reported as 3-4/10 levels. Slight touch to her upper back at T1 to T5 was also painful, reported as 4-5/10.  Slight touch to her face at cheek and corner of eyes was also painful, reported as 2-3/10. Slight touch to her shoulders on joints were also painful, reported as 4-5/10. Slight touch to her lower back on about L2 to S3 was also painful, reported as 1-3/10.  The Ears Pressure Test showed that there was significant painful sensation to touch in the corresponding parts of her head, neck, waist, leg, shenmen and stomach. She described her level of pain in these areas as 6-7/10. Her neck stiffness worsen with rotation of her head and neck. Her tongue was medium sized, teeth mark on the end, and crease line in the center with pale red, a thin white color. Her pulse was thin, wiry and superficial in both lung position. She had a tire and depressed expression on her face.

Based on above information it was summarized that she had migraine headache and neck pain, and pain in the face, back and shoulders.  She had stress, anxiety, and depression and sleep problem. She also had allergies and sinusitis. I name these syndromes together as “PEA” syndromes, which means Pain, Emotional and Allergies combined together. She had a mixed migraine headache, post traumatic headache and cervicogenic headache.  The treatment was: step one, selection of auricular acupuncture with acupressure points such as head, neck, lower back, shenmen and stomach. She felt ear warm, relaxation, and nose open and better breathing, pain in neck, shoulders mildly improved in 5 minutes after ear acupressure therapy. This action also to calm, relax and open up nasal congestion of allergies and sinusitis. It often is effective within five minutes. Step two, using manual acupuncture with selection of acupuncture Taiyang, LI4 and ST36 for pain, stress, anxiety, sleep disorder and digestive problems. Acupuncture LI20, LI4, Yintang to help allergies and sinusitis. Step three, selection of electric acupuncture on the DU20, Yintang, et al. for 15 minutes, it is especially effective for stress, anxiety and poor sleep and help with pain.  Step four, After 15 minutes, remove all needles, and then acupuncture on DU15, et al., Huatuojiaji T1, et al.,which is especially effective for neck pain.  Last step, after all the above, she felt her neck pain was much better but still felt stiffness and tightness on left side neck at around C6 to C7, so acupuncture was applied on Yaotongxue on hand meanwhile the patient was asked to bend, twist and rotate her neck, head and shoulders about 2 to 3 munities. After 40 minutes of procession she felt relaxation, nasal congestions improved a lot, pain in the neck, shoulder, and head also improved a lot. After one week, she called to report that she did not have neck pain and migraine headache since last treatment. She happily canceled her next appointment.

I often use this protocol for treatment for pain with muscle spasms, stiffness in difference local such as neck, back, chest, hip, knees, legs, ankles, heel, shoulders, arms and hands.