Just about everyone has had some type of headache at one time or another. Generally, a one-time headache doesn’t cause too much of a concern but chronic or severe headaches can be quite debilitating.
Headaches in Western Medicine
According to western medicine, there are many causes for headaches such as tension, stress, referred pain from trigger points, infections and fevers, cardiovascular problems (hemorrhage), neurological problems (migraines, cluster headaches, trigeminal neuralgia), drugs or withdrawal from drugs, as well as environmental, chemical, and traumatic events, just to name a few.
Generally, to treat headaches western medicine uses analgesics and non-steroidal anti-inflammatory drugs (NSAIDS), ergotamine/cafergot/ergodryl, pizotifen/sadnomigran, and sumatriptin/imigran.

Man with Headache — Image by © moodboard/Corbis
Headaches in Chinese Medicine
In Chinese medicine, headaches that are acute and short lived are generally due to exogenous invasion of wind, cold, damp and heat. Other contributions include emotional factors, diet, overwork, constitution, trauma, and stress. These are then separated in to excess or deficient types, along with area of distribution.
- Yang Ming: frontal distribution, along the forehead and under the eyes, associated with the Stomach meridian
- Shao Yang: temporal distribution, from the temples to behind the ears, associated with the Gallbladder meridian
- Tai Yang: occipital distribution, along the nape of the neck, associated with the Urinary Bladder meridian
- Jue Yin: vertex distribution, at the top of the head, associated with the Liver meridian
Based on the pain associated with these areas, differentiations are given:
Pattern | Headache | Other Symptoms | Prescription | |
External |
Wind Cold | Occipital, stiff neck | Aversion to wind & cold, chills & fever, no sweating, muscle aches, nasal obstruction or runny nose, thin white tongue coat, floating (tight) pulse. | Chuan Xiong Cha Tiao San |
Wind Heat | Frontal | Fever, red face/eyes, thirst, dry cough or cough with sticky yellow sputum, sore throat, red tipped tongue, yellow coat, floating (rapid) pulse. | Xiong Zhi Shi Gao Tang | |
Wind Damp | Occipital, or Frontal, heavy head stiff neck | Chills, mild fever, muscle and joint pain, loss of appetite, nausea, vomiting, loose stools, thick greasy white tongue coat, floating (soft soggy) pulse. | Qiang Huo Sheng Shi Tang | |
Summer Heat | Frontal | High fever, sweating or hot dry flushed skin, dryness and thirst, scanty and concentrated urine, vomiting and diarrhea, dry yellow tongue coat, rapid (strong or fine) pulse. | Xin jia Xiang Ru Tang | |
Internal |
Liver Qi Stagnation | Recurrent Occipital or Temporal worse with stress | Stiff neck and shoulders, muscular tension, depression, premenstrual syndrome; may have constrained heat such as flushing, red sore eyes, heartburn, bitter taste, normal or purple tongue, may have red edges, wiry (rapid) pulse | Xiao Yao San; Jia Wei Xiao Yao San |
Liver Fire | Temporal; Severe, pounding, splitting worse with alcohol, stress | Flushed face, sore red eyes, bitter taste, constipation, scleral hemorrhage, bad temper, premenstrual syndrome, red tongue, thick yellow dry coat, wiry strong rapid pulse during headaches | Long Dan Xie Gan Tang | |
Hyper Liver Yang, Liver Wind | Temporal, Vertex; splitting | Dizziness, visual disturbances, nausea, vomiting, red complexion, anger, insomnia, low back ache, heat in the chest, palms and soles, night sweats; muscle spasms and tremors, numbness, red tongue with little coating, or a peeled coat, wiry strong and rapid pulse | Zhen Gan Xi Feng Tang; Tian Ma Gou Teng Yin | |
Cold in Liver & Stomach | Vertex, Temporal | Vomiting, cold intolerance, cold extremities, hyper salivation, pale tongue with white coat, slow wiry pulse | Wu Zhu Yu Tang | |
Phlegm Damp | Dull, aching, heavy | Vertigo, poor concentration, foggy head, nausea, vomiting, chest oppression, swollen tongue with a thick greasy coating, slippery pulse | Ban Xia Bai Zhu Tian Ma Tang | |
Blood Stasis | Intense, focal, stabbing | Purple lips, sclera, conjunctiva and nail beds, vascular congestion, depression, premenstrual syndrome, left iliac fossa pressure pain, purple tongue, choppy pulse | Tong Qiao Huo Xue Tang, Xue Fu Zhu Yu Tang, Fu Yuan Huo Xue Tang | |
Stomach Heat | Frontal, ass. With specific foods | Epigastric pain, indeterminate gnawing hunger, heartburn, halitosis, sore gums, thirst, constipation, thick yellow tongue coat, slippery strong pulse | Qing Wei San | |
Stomach & Gallbladder Disharmony | Frontal, Temporal; pounding | Nausea, vomiting, bitter taste, belching, flatulence, abdominal and hypochondriac pain, greasy white or yellow tongue coat, slippery wiry pulse | Huang Lian Wen Dan Tang | |
Qi Deficiency | Dull, worse in morning, with cold and fatigue | Fatigue, poor immunity, pale complexion, breathlessness, weak voice, spontaneous sweating, poor appetite, pale tongue, weak pulse | Bu Zhong Yi Qi Tang | |
Blood Deficiency | Dull, worse with blood loss, menses, eyestrain, evening | Pale complexion, conjunctiva and nail beds, dry hair, skin and eyes, postural dizziness, insomnia, palpitations, scanty or irregular menses, low energy reserve, pale thin tongue, thready pulse | Jia Wei Si Wu Tang | |
Kidney Yin Deficiency | Chronic, dull, worse with exertion, sex, evening | Dry skin, hair, eyes, vagina, mouth and throat, warm and dry palms, flushing, night sweats, lower back and leg pain, dizziness, tinnitus, muscle spasms and calf cramps, insomnia, dry stools or constipation, red dry tongue with little or no coat, thready rapid pulse | Qi Ju Di Huang Wan | |
Kidney Yang Deficiency | Chronic, dull with empty cold feeling | Cold intolerance, cold extremities, low back ache, nocturia, copious thin watery leucorrhea, pale swollen and scalloped tongue, deep slow weak pulse | You Gui Wan |
There are many different causes and types of headaches. The formula Chuan Xiong Cha Tiao San in often used to treat any type of headache.
So, before you lose your head, visit an Acupuncturist or Traditional Chinese Medicine Practitioner to see how Chinese medicine can help you
Caroline Prodoehl, R. TCMP
References:
MaClean, Will & Lyttleton, Jane. (2010). Clinical Handbook of Internal Medicine: Treatment of Disease with Traditional Chinese Medicine – Vol. 3 Qi Blood Fluid Channels. Pangolin Press. Hong Kong.