I remember the first time I had a migraine. It was a typical, sunny and humid 95 degree summer day in Virginia, and I had just driven to work to start my high school job at a pharmacy. As I got out of the car, all of a sudden I realized that I was seeing stars, but only out of one eye. As I started my work day, the vision disturbance got worse and worse, until only my peripheral vision was left. My head hurt slightly, but this definitely felt different from any headache I’d had before. The pharmacist at my job advised me to have a cup of coffee- she said caffeine was good for a migraine. It clicked: “Ah, so this is a migraine!” Gradually my vision improved and I could see again.

As someone who has experienced years of chronic tension headaches, and occasional migraines, I can tell you that I understand the feelings of frustration and fatigue that come along with constant pain. Like many people, I eventually resigned myself to thinking this daily pain was the new normal, and I didn’t notice it that much after a while. However while I was in acupuncture school, I decided to try treatments in the student clinic and see what might happen. Just a few acupuncture treatments completely got rid of my daily tension headaches, and greatly reduced my migraines. Now that I have been practicing acupuncture for 10 years, I can tell you that my experience was not unusual- acupuncture is enormously helpful to my patients with headaches and migraines and I can’t recall a patient who didn’t experience at least some reduction in pain.

Who Might Want Acupuncture Instead Of A Medication?

There are so many reasons why people might need an alternative to traditional migraine medications:

•  You would like to find an alternative to taking daily medication for your headaches
•  You already take daily medication to prevent migraines, but want to minimize episodes when you need to take other medication for increased pain.
• You’re unable to tolerate side effects from either prescription or over the counter (OTC) medications
• After trying all medication options, you are still unable to successfully manage symptoms
• You are pregnant (or would like to be). During pregnancy many migraine medications are not safe, and although for some women migraines tend to greatly decrease during the second trimester, this is not always the case.
• You have heart disease or high blood pressure. Some migraine medications are contraindicated for patients with these conditions.
• You experience rebound headaches, which can happen a few hours or days after taking a pain medication

All of these are great reasons to look closely at factors in your lifestyle that could be contributing to migraines and headaches such as diet, stress level, sleep patterns and hormonal imbalance, and see what you can do to minimize pain frequency. When these changes are not enough,  when stress is a major trigger or if medications are being overused, it’s time for acupuncture. It’s safe, it’s drug-free, has little to no side effects, and most importantly it WORKS.

Types of headaches

There are two major classifications of headaches: primary and secondary. Primary headaches can be either recurrent or episodic (meaning they happen on a regular basis or every once in a while). Types of primary headaches include migraines, cluster and tension headaches. Secondary headaches involve pain for a distinct physical reason: such as fever, tooth infection, caffeine withdrawal and sinusitis.

• Tension Headaches usually are mild to moderate in severity and cause pain over the entire head, and can last hours or even days. These are usually due to neck or upper back tension, TMJ dysfunction (jaw tightness), and even eye strain. They normally get worse as the day progresses, and aren’t usually present upon waking up in the morning. Relaxation and stress management are extremely important in managing tension headaches, and I have also found acupuncture to be very effective.
• Cluster headaches usually affect men between the ages of 20-40 years old and, as the name implies, occur in groups. Pain from a cluster headache begins very suddenly and is quite excrutiating, one-sided pain which can be accompanied by one eye watering, facial flushing and/or congestion. The pain usually lasts about 30 minutes. These attacks continue for anywhere from 1-3 months, after which a person may never experience one again, or it may be months or years till the cycle repeats.

What Is A Migraine?

A migraine is described as a “neurovascular pain syndrome”- say what? This is just scientific terminology meaning that blood vessels in the head and/or brain are dilating, which causes pressure on the nerves inside the brain. This pressure is what results in changes to your ability to see, smell or hear normally as well as throbbing pain and occasional tingling on one side of the body. Researchers have found that there is a strong genetic link to migraines- if you get migraines, chances are someone else in your family does, too.

What Is The Difference Between A Migraine and A Headache? 

Strictly speaking, a migraine is considered a type of headache. But the real difference is that a headache is just one of the many things people experience while they have a migraine. If you have a headache, pain in your head is really your only symptom.

Migraines are caused by dilation of blood vessels in the brain and head. Headaches (due to tension or dehydration) involve the opposite: constriction of blood vessels. But symptomatically, how can you tell you have a migraine, and not simply a headache? It’s not always clear, and surprisingly people are often misdiagnosed.

• When someone has a migraine, there are almost always other symptoms that happen beforehand or at the same time which are collectively called an “Aura”. An Aura can include nausea, sensitivity to light, seeing flashing lights, sensitivity to sound or odor (including olfactory hallucinations- thinking you smell something that isn’t really there), tingling in one hand or one side of the face, or even speech disturbance.
• With a migraine, a person can also have difficulty concentrating and symptoms become worse with increased activity.
• Migraine  pain is usually (but not always) at the forehead or temples, can be one-sided or over the entire head, and can be described as either aching, throbbing or squeezing pain.
• One key difference between migraines and headaches that many people aren’t aware of is that migraines don’t always cause pain, but headaches do. Someone can have a migraine and only have the aura symptoms- but little to no pain.

What Does Acupuncture Do To Stop Migraines and Headaches?

Acupuncture helps to treat and prevent migraines and headaches by several mechanisms: it can relax tight or strained muscles in the upper back and neck which lead to head pain, it increases activity in brain centers involved in rest and relaxation, and decreases activity involved in pain recognition, and it decreases unnecessary activity in the sympathetic nervous system. The sympathetic nervous system is what becomes activated in emergency, “fight or flight” situations, and for people who are chronically stressed it can be active much more often than it should be. This over-activity can lead to migraines, insomnia, sleep disturbances, and digestive issues. Acupuncture is fantastic for normalizing the nervous system’s functioning. This is one area in which the research so strongly backs acupuncture’s efficacy, that it is one of the few conditions for which insurance companies will always cover treatment.

NY Times Article: Acupuncture Provides True Pain Relief in Study

Study: Acupuncture for Chronic Pain

Reuters Article: Acupuncture Beats Aspirin for Chronic Headache

Article: How Can I Manage My Migraines During Pregnancy?

Study: Acupuncture in the Prophylactic Treatment of Migraine Without Aura

How Often Will I Need To Come For Acupuncture?

This all depends on how frequently your migraines are occurring, what your triggers are, and whether you have recently discontinued other migraine medications. Most patients come once to twice weekly at the beginning of their course of treatment, and as they see improvement, decrease acupuncture to every 2 to 4 weeks. I have one patient who experiences premenstrual migraines and so she finds that simply coming in the week before her period is enough to prevent or minimize symptoms.

My recommendations and Lifestyle Tips

• Try to go to sleep and wake up at the same time every day, whether it’s a holiday, workday or weekend. Changes in your sleep/wake cycle are a major trigger.
• Avoid common food triggers such as alcohol (especially red wine), caffeine, artificial sweeteners, and known foods which are vasodilators including chocolate, some fish, nitrates, and MSG. Stick with a whole food-based, unprocessed diet whenever possible (this just means a diet where you cook foods yourself, or don’t have to guess at any ingredients in your food).
• If you experience hormonal migraines (usually premenstrual), schedule fewer activities and ease up on unnecessary tasks for a week beforehand. This is also a great time to get acupuncture.
• Regular exercise can be beneficial. If you find that intense exercise triggers headaches or migraines, do a gentle yoga class or go for a walk instead.
• Avoid looking at electronic devices for too many consecutive hours, as bright light or eyestrain can be a trigger. I recommend f.lux, which you can install on your computer or smartphone to automatically change the computer display to match the level of sunlight in your time zone. It mimics sunlight during the day, and mimics warm indoor lighting in the evening.

I now realize that my migraines are actually quite typical: They are triggered by changes in barometric pressure and exposure to bright light and I experience vision disturbances and pain over just one eye. My situation is luckily pretty mild- my migraines only happen a few times a year and aren’t totally incapacitating. As is typical with very minor migraines, lying down with my eyes covered in a completely dark room gets rid of the symptoms within 30 minutes to an hour. However I’ve had many patients over the years who have had migraine symptoms so severe, and experience migraines so frequently, that their work and personal lives are severely disrupted. Acupuncture treatments for migraines are something I emphatically recommend.  As a preventive treatment, acupuncture can reduce both the frequency and intensity of migraines and chronic tension headaches.