Headache — frontal

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Textbook Prescriptions Headache and Dizziness

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

ST8 Touwei bilateral

Stomach point at the corner of the forehead; local point on Foot-Yangming
EX-HN3 Yintang midline

Extra point between the brows; local point for frontal pain
GV23 Shangxing midline

Governing Vessel point above the hairline; local point for the forehead
LI4 Hegu bilateral

Yuan-Source of the Large Intestine; distal Hand-Yangming point for the face and forehead
- Pregnancy: contraindicated
ST44 Neiting bilateral

Ying-Spring of the Stomach; distal Foot-Yangming point for the forehead

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

No cited needling data yet for EX-HN3. No flag here does not mean no risk.

Treatment Principle

Dispel wind, open the channels and regulate qi and blood by pairing local forehead points with distal Yangming points.

Indications

Pain at the forehead and above the eyes (Stomach channel, Foot-Yangming)excess type: violent boring pain with dizziness, irritability, bitter taste, nausea, chest oppression, hypochondriac pain, sticky tongue coating, wiry pulsedeficient type: dull pain brought on by strain, eased by warmth and pressure, with fatigue, palpitations, poor sleep, pale tongue, weak pulse

Method

Reducing method for the excess (liver yang) type; reinforcing method, or tapping with a cutaneous needle, for the deficient (qi and blood) type.

⚠ Cautions

A sudden severe ('worst ever') headache, headache with fever and neck stiffness, neurological signs, a new headache after age 50, or headache after head injury needs urgent medical assessment before acupuncture. LI4 is contraindicated in pregnancy.

About

The textbook's prescription for headache across the forehead and brow ridge, which it assigns to the Yangming channels.

Rationale

Three local points over the forehead treat the site of pain, while LI4 on the hand and ST44 on the foot reach the same region through the Hand- and Foot-Yangming channels. The local and distal points together clear the channels and settle the pain.

Clinical Notes

Points by pattern: for rising liver yang, add LV2 and GB34; for deficient qi and blood, add CV6 and ST36. The book notes that headache arises in many medical, surgical, neurological, psychiatric and ENT conditions, and that acupuncture works well for migraine and for vascular and functional headache. It also describes cutaneous-needle tapping with cupping and an ear-acupuncture option.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Headache, p. 336–338.

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