Headaches and severity of pain

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The first thing to consider regarding headaches is are the headaches

due to Exterior Causes, Interior Causes, or a combination of

Exterior and Interior? Since this is a post for readers new to TCM

as well as TCM students, I'm going to define some of the basics.

 

The term " Exterior " refers to the head, neck, shoulders, arms, legs,

skin, muscles, meridians (pathways of Qi flow), and bones. The

term " Interior " refers to the Organs. (TCM Organs are capitalized

because they are not equivalent to anatomical organs but collections

of functions. But don't worry about exactly what this means at the

present. This is not necessary to understanding the info about

headaches.)

 

TCM pays a lot more attention to weather conditions and sensitivity

to weather conditions than allopathic medicine does. There is a

special kind of Qi called Protective Qi (or Defensive Qi) that

circulates at the surface of the body and gives resistence

to " Pernicious Evils " (Wind, Cold, Heat, Dampness, and Dryness) in

the environment. People who are weather-sensitive lack sufficient

Protective Qi. Sometimes the Protective Qi Deficiency is temporary,

but sometimes it's chronic.

 

The headaches due to Interior causes are due to changes in the

Organs. For example, Liver Yang Rising. Readers who are new to TCM,

don't worry about understanding what that is for the time being.

It's an imbalance of the Liver (note the capital L) in which too

much Yang Qi rises to the head and triggers a headache.

 

The headaches which are due to both Exterior and Interior imbalances

can be among the worst and most chronic of headaches.

 

In general, headaches primarily due to Deficiency (there not being

enough of something) are less painful than headaches due to Excess

(there being too much of something). For example, Liver Yang Rising

is Excess. Too much Yang Qi is going to the head. Liver Yang Rising

headaches are very painful and can be debilitating.

 

For the students: There are several types of Excess imbalances, and

even among Excess conditions, there is a graduation of pain

severity. Both Qi Stagnation and Blood Stasis are Excess imbalances,

but the pain from Blood Stasis is much more severe than that from Qi

Stagnation.

 

When there are both Exterior and Interior imbalances involved in the

headache, the pain can become quite severe and chronic. Let's look

at one example of a sequence of what can go wrong. BTW, this is an

example that ties into the previous post on edema and Blood Stasis.

 

The person is chronically Protective Qi Deficient. Because of this,

the individual is very vulnerable to Pernicious Evils in the

environment: Wind, Cold, Dampness, Heat, and Dryness. Wind

Cold " invades " the Bladder meridian. The Bladder meridian starts on

the head and transverses the back of the neck and the back and the

back of the legs. The back of the neck and the back of the head

becomes stiff and in time swollen. The Wind Cold may be only on one

side of the body (and the headache is one-sided), or it can be

bllateral, and both sides of the head hurts. When the Wind Cold

invasion is one-sided or primarily one-sided, one can feel the

difference between the two sides of the back of the neck. One side

is hard and swollen, and the other side is more normal. In severe

cases, one can even see the difference.

 

Invasion by Pernicious Evils is an Excess imbalance, so the pain is

going to start out fairly severe. However, for a person who suffers

chronic headaches, this is not a debilitating pain. The person has

so many headaches that the person learned long ago to try to ignore

the pain and carry on the best s/he can. However the longer that

Perncious Evil or Evils stay lodged in the Exterior, the more severe

the headache is going to get over time. Keep in mind that chronic

headaches often are occuring not just against a background of

chronic Protective Qi Deficiency but also chronic Qi Deficiency

and/or Blood Deficiency. it's hard for the person with Qi and/or

Blood Deficiency to " kick " the Pernicious Evils out.

 

Remember the part in the previous post about edema and inflammation

can trigger Qi Stagnation and Blood Stasis? That's what happens in

these cases as the neck muscles stay stiff and swollen. As Qi

Stagnation gets worse and worse, the headache gets worse and worse.

When Blood Stasis starts to set in, the pain not only gets a lot

more severe, it gets debilitating. The person is incapable of doing

much besides sitting up or lying down. Movement can make the pain

worse. Vomiting also can occur because one effect of severe pain is

it can cause Stomach Qi to Rebel, to rise rapidly.

 

When a Blood Stasis headache sets in, aspirin is useless in

relieving these headaches. Even some narcotics at best only blunt

the pain. The headache is not going to go away until the Wind Cold

is expelled from the body. Some sufferers of Wind Cold headaches

against a background of Qi Deficiency and/or Blood Deficiency

discover on their own that a heating pad applied to the back of the

neck helps some. Note I said some, as in some of these

cases " helping some " means the headache only lasts for a day instead

of several days. There are other places to place the heating pads

that act a lot quicker than putting a heating pad on the neck.

 

There are acupoints that will work to expel Pernicious Evils from

the body. One of these is Small Intestine 3. It's on the outer edge

of the hand near the top next to the knuckle. There are other

acupoints that work to strengthen Deficient Organs that play a role

in the person being prone to headaches. For example, working Bladder

23 will strengthen the Kidneys. Depending on the invidual's exact

clinical picture, there are other combinations of acupoints that can

work wonders. I recommend trying a heating pad on Bladder 23 and

one on Small Intestine 3 in Wind Cold Invasion against a background

of Kidney Yang Deficiency. If the headaches are due to Wind Heat

invasion against a background of Kidney Yin Deficiency, obviously

you don't want to apply heat to these points. Try massaging them.

 

In addition, there are herbs and herbal formulas for Expelling

Pernicious Evils. There also are herbs like astragalus for

increasing Protective Qi. But one doesn't want to take astragalus

before expelling the Pernicious Evils or curing the cold or flu.

(Professional herbalists know how to tonify and expel at the same

time, but people working on their own without a TCM header are

advised to not tonify until after the Evils are expelled.)