Headache & migraine treatment options

Got a headache? The biggest cause is dehydration, so first, have a drink of water. Other common causes are caffeine withdrawal, high blood pressure, stress, low blood sugar, and tight neck muscles. If you have persistent or severe headaches, you should get them checked out by a healthcare professional (If only so they can say “It’s not a tumah!”), but for minor annoyances you can treat it yourself with acupressure (points listed below).

Human skull bonesI usually find that migraines are caused by hormonal imbalances, or by neck muscle tension pulling on cranial bones. Our skulls are not a giant fixed globe: There are lots of different plates and oddly shaped bones that make up our brain protection. The joints (called “sutures”) are shaped like jigsaw puzzles.

My favorite cranial bone, the sphenoid. It barely shows at the side of the head, but inside it makes a gorgeous butterfly shape. When torqued, it also gave me a monstrous migraine headache!

My favorite cranial bone, the sphenoid. It barely shows at the side of the head (it’s pink in the other picture), but inside it makes a gorgeous butterfly shape. When torqued, it also gives me a monstrous migraine headache! I keep my sphenoid happy by getting care for my neck, and using the acupressure points below when one threatens to attack…

 

Our bones move with a subtle pulsing called the craniosacral rhythm. If the neck muscles attached to the skull get too tight, they can jam up those joints and cause migraines. The fix: Acupuncture and medical massage for the muscles involved. Craniosacral therapy by a skilled practitioner is also wonderful, but be sure to see someone who’s thoroughly trained. A weekend seminar is not enough! If there are hormonal causes, acupuncture is superb for that as well.

Here’s a handy acupressure point for any headache, including a migraine: It’s in that “second piercing” spot, below the anti-tragus. Press firmly for a few seconds. If you have an earring in, you should remove it if possible, at least until your headache passes. For more information on ear points, check out this article. Also, look at LI-4KD-1, and GB-21 and TB-5  if you have neck tension. Definitely read this if you’re considering a Daith piercing. 

Press firmly with a fingertip or fingernail. It will hurt, but it'll be worth it!
Press firmly with a fingertip or fingernail to stop a headache or migraine. It will hurt, but it’ll be worth it!

 

Ear seeds – Radishes for reflexology!

If you ever attend an event with me, soon you’ll notice people walking around with funny little stickers on their ears. Ear seeds are my mobile acupressure strategy. When people come up to me and ask what I can do about their back pain in the middle of a party… BAM! On go the ear seeds. These are radish seeds on a tiny piece of band-aid tape. There’s nothing magical about the radish – they are just the right size and shape to apply acupressure to any of the 100 points on your ear (map below).

You’re familiar with reflexology, right? You know how your entire body is reflected on your hands and feet? Same deal with the ears. I can treat pain or dysfunction anywhere in the body, emotional upheaval, anxiety, etc. This is why I’m not a huge fan of lots of piercings. It’s also why ear massages are like getting a full body massage, and terrific for immediately calming someone down. Try it the next time your migraines act up, your dog is freaked out, or your sweetheart has road rage. :) Just gently rub the entire ear – don’t worry about hitting specific points for this purpose.

Once the seeds are on, they are working. They will last 3-4 days, and you can shower normally. If you want to give the treatment a boost, and can’t feel them on your ears, give them a gentle squeeze to wake them up. If you are already aware of them, leave them alone… they will probably be pretty tender to the touch! Sometimes people find the ear seeds annoying or sore, particularly if they are side-sleepers or they are working superhard (the more active a point is, the more it can hurt). In that case, just take them off. The point is to make you feel better!

I never charge for ear seeds. Ask me for them anytime – I always have them in my purse, and you are welcome to drop by the clinic for a quick installation.

Note: Some people use ear staples for quitting smoking, weight loss, etc. I prefer earseeds, since sending someone out with an open wound is an invitation to infection. Acupressure is hugely powerful and hurts less, too!

There are about 100 points on the ear, so I can treat nearly anything. Ear seeds are quick, portable, and give you a few days of acupressure.

There are about 100 points on the ear, so I can treat nearly anything. Ear seeds are quick, portable, and give you a few days of acupressure.

Anti-inflammatory HTPT – Smell like pancakes *and* feel better!

Last month I mentioned that I was having some trouble with my Arnica distributer (problem resolved – it’s in stock and ideal for bruises, sprains, and strains). I found a fantastic solution: Hai Tong Pi Tang. This is an ancient Chinese anti-inflammatory formula, containing frankincense, myrrh*, saffron, and a number of other herbs. The tincture is in an alcohol base, and made by a local acupuncturist. It comes in a spray bottle, so you can easily apply to any injured or inflamed area. External use only, and not on broken skin, please!

Here’s a fun bonus: The aromatic herbs combine to create a “pancake” scent. Much nicer than Ben-Gay or the usual herbal stinkiness! Watch out, though, you might get nibbled on by fans of maple syrup. :) 1oz bottle for $12, or 2 oz for $24.

frankincense resin

Frankincense resin – anti-inflamatory, anti-bacterial, and calming.

*Frankincense and myrrh have been “Moving” herbs in the Chinese pharmacopia for thousands of years. They are used to treat “stagnation,” which translates to muscular stiffness and pain, among other things. I was once on a cross-country flight when my back seized up. This was early in my acupuncture schooling, while I was still recovering from a traumatic car accident. Somehow I had neglected to pack any anti-inflammatory medication, and the flight attendants weren’t allowed to give me any. I was in so much pain, and I had hours left in that horrible seat! Then I remembered that I had brought along my herb samples to study for an identification test the next Monday. I ate the frankincense and myrrh samples – something I DON’T recommend, as they taste terrible! – and within 20 minutes my pain was gone. I’ve been a big fan ever since.

Damp (a Chinese medicine concept)

I’ve talked briefly before about Fall in the Pacific Northwest, but let’s get into some more details about how the weather here literally leads to Damp in our bodies. I was out playing in our great outdoors, and on the way back, a fellow adventurer asked me if the soggy Portland climate affected how I practiced. It was an interesting question, so I figured I’d share my response.

In Chinese medicine, you can be “invaded” by EPIs – External Pernicious Influences:  Heat, Cold, Damp, Dryness, and Wind (There are actually two types of Heat, but I’m simplifying here). Damp Heat infection examples include yeast and urinary tract infections. Damp Heat in the Gall Bladder* can cause jaundice.

Damp can also start internally. Remember that in this system we have energetic organs* with special duties. The Spleen transforms food into energy (I think they actually meant the pancreas!), and is important in fluid management. If the Spleen fails, or if there is an invasion, fluids accumulate into Damp. A classically Damp body is overweight. Other symptoms include heavy limbs, stiffness, and edema (fluid retention). Damp left unchecked can further consolidate into Phlegm. This may be literal mucus or lipomas (fatty tumors), or “invisible Phlegm” like brain fog or even depression.

Oregon is, of course, a very wet place! Whether the rain itself penetrates us, or the fact that hiking isn’t as much fun when you have to slosh through the mud… either way, living here can definitely contribute to obesity. Alcohol and dairy are the two biggest Damp culprits in our diet. Microbrew and local cheese, anyone?

Be sure to get off the couch and enjoy the sun when you can. Try not to get soaked – a light rain jacket and hat can really make a difference. Nourish your Spleen with hearty cooked vegetables. This is especially important going into Fall and Winter, but don’t neglect them in favor of a completely raw diet even in the Summer.

Acupuncture is a great way to drain Damp, clear Heat, and restore balance to your system. Please ask if you have any questions!

* Energetic organs are typically capitalized to emphasize their distinct nature from our literal, anatomical organs.

 

 

“Dry Needling” vs. Acupuncture

I had a gentleman ask me last week if I had heard of “dry needling” and if I ever did it. I was flabbergasted… Dry needling is what acupuncture is called when non-acupuncturists do it. Wait – that’s not quite right. It’s what using acupuncture needles is called when someone else does it… but that doesn’t make it acupuncture. True acupuncture requires an understanding of a complex system, while most “dry needling” courses are surprisingly brief.

When comparing acupuncturists vs other practitioners as providers of therapeutic needling, some interesting things come to light. I feel very strongly that the various types of medical providers each have their areas of expertise. A bad injury, a serious infection, and organ failure are just a few of the problems that would send me running to “Western” modern medicine. But in some cases – chronic pain, healing after an injury, neurological repair, anxiety, etc. – acupuncture is highly effective. So….Why not just have your doctor do it?

There are some advantages to doctors doing acupuncture. First, they have a more extensive knowledge of anatomy than the average acupuncturist. I was very lucky to get to work with cadavers when I was at chiropractic school – most don’t. Secondly, the procedure is more likely to be covered by health insurance.

Unfortunately, there are also some disadvantages. Doctors are usually MDs first, and have taken a seminar on acupuncture. This course is a few weekends of instruction. They learn a handful of “recipe” points that are based on symptoms. Some people doing “dry needling” are physical therapists or chiropractors. As a comparison, I have a Master’s degree from OCOM, which consisted of 3,344.5 total hours, including 996 clinical hours. I learned about the Zang Fu organs, the channels, and the 1000 points and how they interact.

Doctors usually don’t spend much time getting to know every detail of your medical history. They tend to have 10 minutes for the whole appointment, and focus purely on your “chief complaint” as we call it in medicine: the main reason you came in. Traditional Chinese Medicine (TCM) is holistic. I prefer to take an hour with my patients. We examine the entire body, not just an isolated part, and our diagnosis is dependent upon that global perspective. For example, you may have a headache due to Liver* Yang Rising, or Qi deficiency, or a Wind Invasion. Or look at it from the other direction: A single diagnosis, such as Kidney Yin Deficiency, can cause varied symptoms like menstrual irregularity, anxiety, vertigo, night sweats… you see the problem. This is why I ask all those rude questions (sorry) in a 10 page form when you come in. What your menstrual cycle is like can actually help me determine how to treat your digestive disorder.

When doctors, chiropractors, and physical therapists use dry needling, especially for internal medicine, their results are not as strong as when a TCM trained practitioner wields the needles. I see this in a lot of research studies that “prove” acupuncture “doesn’t work.” It’s roughly equivalent to testing antibiotics for a runny nose, without separating out bacterial infections from viruses and allergies, then claiming that pharmaceutical drugs aren’t effective.

In this article, a doctor writes about needling. The myofascial part is spot on, but he’s missing the energetic component. Some of the points work on areas far away from where the needle goes! LI-4 and LV-3 are beautiful examples of powerful points that don’t really make sense with the Western understanding of anatomy. If distal points like the hands, feet, scalp and ears are neglected, the treatment may be weaker than ideal. It’s something to think about when comparing someone offering dry needling vs a true acupuncturist.

People with only basic anatomy training like massage therapists, and physical therapists doing dry needling? Super bad idea – and the reason there are so many news stories about dry needling pneumothorax (collapsed lung) problems created by physical therapists. Acupuncture needles are controlled as a medical device, because they really shouldn’t be used by amateurs.

Dry needling is a bad idea, m'kay?

Dr. Andrew Weil, M.D., agrees that TCM training should be comprehensive.

*Remember that in Chinese medicine, capitalized organs are energetic concepts and should not be confused with your anatomical organs.

Yin & Yang

*Note – some parts of this discussion were previously published in the Stroke article.

Chinese Traditional Medicine (TCM) goes back to 2000 BC in its current form, and in its antiquity goes back at least 5,300 years! It’s based on energy movement throughout the body along specific paths or “channels.” Acupuncture works by manipulating energy at points where that energy flows near the surface. There are about 1000 distinct points all over the body, each with their own unique qualities. I came to acupuncture as a profession when it was the only thing that could stop my back pain after a severe car accident (I’m now completely recovered). When I first started studying I was a little skeptical – I was a hard-core scientist and figured the map of channels was an elaborate way to memorize nerves and other anatomical landmarks. The more I studied, though, the more I came to see that this is a completely different system of physiology.

After years of seeing the power of this odd system at work – on skeptical humans, on animals, on “impossible cases” – my current belief is that this is a form of energy we just can’t explain yet. If you told a 16th century doctor that you could see inside the human body without cutting it, you would be declared a witch. Now, any x-ray or ultrasound technician has that ability. NIH has been funding research into measuring energy flow along the channels. It’s only a matter of time before TCM becomes part of our accepted science of medicine.

We’ve all heard of Yin and Yang (pronounced to rhyme with Pin and Pong, by the way). They are tossed around in popular culture a lot, generally with a superficial understanding of them as two sides of a whole. I’ve even seen them likened to Superman and Clark Kent! In Chinese medicine, however, they have a very specific meaning.

Think of Yin as being the moist, nourishing, quiet, still, internal, “feminine” aspect of your being. Yang is the other side of the coin: It’s the loud, bright, moving, motivating,expanding, “masculine” side of you. See how the white Yang is rising, while the black Yin is descending? Note also that each contains a bit of the other: They are incomplete without the other half of the pair. There is a delicate balancing act between the two types of energies, and they influence each other. When Yin and Yang separate (in a raging fever, for example) the patient will die.

Yin/Yang: Each contains and is dependent on the other to create a whole.

Think of an animal, or a baby crawling on all fours. As applied to anatomy, the front and lower parts of the body are Yin. The back and upper body are considered more Yang.  On the limbs, inside surfaces are Yin and the outside aspects are Yang. Acupuncture treatments must be planned out so they contribute to balance. For example, if someone has a headache, we don’t just use local needles on the scalp. We use points on the hands and feet to distribute the input to the body. There’s a great point on the sole of the foot that will draw excess energy down, which helps a lot with Yang-rising types of headache.

 

Yin and Yang energies must work together, and should give and take throughout the day. Yin predominates at night, while Yang rules the day. Some hormonally based examples may be helpful: A woman going through menopause is Yin deficient. Her Yang, no longer held in check by her Yin, causes hot flashes, night sweats, and dryness of the skin and other bodily fluids. To ease this “change of life,” we start by using acupuncture points to clear excess heat (the symptoms). Other points act to nourish the Yin (the cause). These treatments are surprisingly powerful for stopping hot flashes.

Likewise, a man as he ages will suffer from Yang deficiency. This is readily identified in the case of erectile dysfunction and decreased libido. Other symptoms can include lower back pain and a general loss of vigor.  In this case, we use acupuncture points that activate the Yang. Some acupuncturists use moxabustion (burning mugwort, an herb in the sage family) to warm and stimulate the Yang, although most modern clinics (mine included) are now using infrared heatlamps. Using modern technology eliminates the chance of burns and makes for a wonderfully relaxing session.

Most patients feel some immediate relief when acupuncture is used to balance Yin and Yang, but longer term hormonal changes will require multiple treatments.

This is a simplified explanation, of course. Masters of Chinese medicine study for years to understand the subtle interplay of Yin, Yang, and the channels. It’s a fascinating tradition with a lot to teach us about the human body.

Du-4 (warm the Yang, lower back pain, low energy, infertility or ED)

Mingmen, the Gate of Life (AKA Du-4) is located in the center of the spine, just below the 2nd lumbar vertebrae. It’s used for building Yang, treating infertility or sexual issues such as erectile dysfunction, and for lower back pain or weakness.

Be careful stimulating this point if you are using acupressure, since it’s often tender.  Applying heat can be useful, especially If you tend to be cold. In my clinic, of course, I use acupuncture and an infrared therapy lamp. At home, you can direct a warm shower stream onto it or use a microwavable rice bag (I have them at the office if you need one).

Also good for lower back pain: LV-3, BL-40 and GB-34.

 

Winter health tips – avoiding colds, SAD, cracked heels, & weight gain

Winter is coming!

In Chinese medical philosophy, infectious illnesses are considered to enter the body at the nape of the neck, so scarves are an important defensive weapon against getting sick. Although I think it has more to do with insulating the carotid arteries at the side of the neck, I am a big encourager of scarf wearing. In addition to preventing infections, a toasty cover will keep your neck muscles warm and relaxed. Pick out a soft, colorful one and give yourself a woolly hug. You can also give your immune system a boost by stimulating TB-5, and including garlic and ginger in your diet along with lots of hearty vegetables.

Don’t be S.A.D.!

If you suffer from Seasonal Affective Disorder, the shorter days can sap your energy and leave you feeling depressed. You need to stimulate your pituitary gland, and the best way to do that is to get some time in front of a full-spectrum light, particularly in the morning. You can just pick up some full-spectrum light bulbs at the grocery store, or you can go in for a fancy “light box.” Soak up some photons at close range for about 15 minutes first thing in the morning, while having breakfast or catching up on Facebook.

Cracked Heel remedies

Winter health tip: keep your heels smooth and pain-free by treating cracks early, before they get out of control!

Winter health tip: keep your heels smooth and pain-free by treating cracks early, before they get out of control!

If your feet have suffered this winter, try this: Before bed, apply a high-quality lotion or wax (I like Waxelene, available at New Seasons. No nasty chemicals!) and put on some clean socks. This will keep the moisturizer on your feet rather than your sheets. I hate the restrictive sensation of wearing socks to bed, so I cut the toes off an old pair, which works beautifully. In the morning, before you shower, use a pumice stone or even a broad nail file on the DRY skin to remove the dead skin. If you have painful, deep cracks, use some SuperGlue (or better yet Dermabond) to hold them closed and continue with the routine above.

Holiday stuffing

Ah, parties and recipes and comfort food… it’s all fun and games until your pants don’t fit, isn’t it?

Think ahead about making good choices. Have a nutritious snack before a party if you suspect the goodies won’t be good for you.

Potluck? Bring something healthy instead of a dessert!

Focus on quality, not quantity. Save your calories for when they count: Skip the storebought cookies so you can splurge a bit on Aunt Susan’s homemade toffee.

Don’t use the “it’s the holidays” excuse from mid-November to the end of the year! ON the actual holiday, of course, allow yourself to indulge a little, but not everyday! That’s a big chunk of the year!

Winter Heath tip: Get some exercise! Peacock Lane (at 40th and SE Belmont) is annual festival of electricity and inflatable animals in human clothes, and makes for a fun walk.

Winter Heath tip: Get some exercise! Peacock Lane (at 40th and SE Belmont) is annual festival of electricity and inflatable animals in human clothes, and makes for a fun walk.

Bundle up and go for a stroll in a winter wonderland! Check out the lights wherever you live. Some light exercise will aid your digestion, mood, and keep your muscles and joints in good shape. Don’t forget your scarf! :)

If you do overeat, use St-36 to promote digestion. This point is great for nearly all stomach complaints, but be aware that it generates more gastric acid. If you’re having heartburn / reflux, use PC-6 instead. To help speed up peristalsis (the movement of food through your intestines), rub your belly clockwise circle (up on the right side of your abdomen, across the top, down on the left). This is good for painful gas retention, too. For small children, just use a few fingers.

I hope you find these Winter health tips useful. Stay warm! :)

LI-4 (headache, arm or facial pain, infection, hot flashes)

LI-4: Hegu. This point is astonishingly useful for a wide variety of complaints, but don’t use it if your patient is pregnant!

Large Intestine 4 is the acupoint most well-known by the general public. I first had it taught to me by a riding instructor when I was a kid living in rural Virginia. The name for this point is Hegu, “Joining Valley,” which is a reference to its anatomical location on the back of your hand, in that fleshy area between the thumb and forefinger. Feel around – it’ll be tender if you need it – but the easiest way to find it is to squeeze your thumb against your hand. The highest point of the muscle is where you want to press. Use firm, gentle pressure for 10-20 seconds with a healing intention. Try both sides.

Hegu, or Joining Valley, is a tremendously useful point. It moves stagnation, so you can use it to clear pain and stiffness anywhere in the upper body. Hegu will be particularly effective along the LI channel, which runs from the nail of the forefinger, along the forearm to the lateral (outside) elbow, up the arm and across the shoulder, eventually crossing the upper lip to end at the opposite side of the nose. Shoulder and elbow pain, carpal tunnel, and (of course) headaches are common uses. It’s specifically the Ruler of the Face, so it’s doubly powerful for frontal headaches, eye pain, sinus blockage, and tooth pain. It also releases heat and is part of a point combination for fighting viral or bacterial infections. If  you are prone to hot flashes, this point could be your new best friend. Also use LI-11, pictured here, to clear heat.

And by the way… the leading cause of headache is dehydration. Drink a glass of water!

WARNING: Because Hegu is a moving point, DO NOT use it if you are pregnant or bleeding. It can induce a miscarriage or increase blood loss. On the other hand, if you are overdue and want to evict your baby, this is a great way to do so, along with some other points (assuming everyone is healthy and it’s not a complicated pregnancy!). It will usually increase menstrual flow if the patient is having her period. If you have a severe headache paired with sudden loss of motor control or speech, get to a hospital immediately. DO NOT use LI-4 until you are sure you are not having a hemorrhagic stroke (bleeding inside the brain). This goes for head injuries, too!

 

Fall Health tips

Autumn is my favorite season. The crisp blue skies, the exploding yellows and oranges in the trees… It makes me crave a walk in the woods and a crunchy, juicy apple. All of a sudden pumpkins are everywhere and I’m looking for a sweater.

 Asian tradition includes responding to the energy of the seasons. This is true both philosophically (Have you seen this beautiful Korean movie?) and physically.  Remember back in the summer when I mentioned cooling foods like watermelon? For fall health, try to eat fewer cold, raw foods like salads, and more warm, cooked meals. Enjoy soups and steamed or baked vegetables such as broccoli and yams. Incorporate yellow and red foods into your diet. Consider starting your morning with hot oatmeal to fuel your day. I love Steel Cut oats! You can get them at most grocery stores, and now  Fred Meyer even has them in the bulk isle!

You want about 1/4-1/3 cup of dry oats per person. The night before your intended breakfast, put the oats and twice as much water into a pot. That means I do half a cup plus a little extra shake for Robert and me (he’s a big guy!), and just over a cup of water. Cover and let soak overnight. In the morning, cook on medium heat for 6-10 minutes, depending on how chewy vs. soft you want your oatmeal.

You can enjoy as is, but I like to toss in some walnuts for some added protein and healthy fats. Fruit (dried or fresh), honey, even maple syrup are options, too. Get creative!

Of course hot tea, in a variety of colors and flavors, is essential for me in the Fall. My favorite when I’m chilled is ginger tea. You can buy packets, but it’s best to just grate fresh ginger into a mug of hot water and add honey. Ginger is supremely warming and a soothing treat for a sore throat. It even boosts your immune system!

There’s an article here about Damp. In Chinese Medicine, colds and flus are considered to enter the body at the nape of the neck. Scarves are an important defensive weapon against getting sick. Although I think it has more to do with insulating the carotid arteries at the side of the neck, I am a big encourager of scarf wearing. In addition to preventing infections, a toasty cover will keep your neck muscles warm and relaxed. Pick out a soft, colorful one and give yourself a woolly hug.