Headache — occipital
StarEssentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.
Points
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Local point below the occiput; dispels wind and frees the channels at the nape
- ⚠ Spinal cord / medulla
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Jing-River of the Bladder at the ankle; distal Foot-Taiyang point for the occiput
- Pregnancy: contraindicated
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Shu-Stream of the Small Intestine; distal Hand-Taiyang point for the nape
Needling Safety
Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.
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GB20 Fengchi
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⚠ Spinal cord / medulla risk: deep or misdirected insertion can enter the spinal canal. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 2 (Central nervous system injury associated with acupuncture); World Health Organization 1999, Section II §5.2 (Central nervous system), p. 25
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Treatment Principle
Dispel wind, open the channels and regulate qi and blood, joining a local point to distal points on the affected channels.
Indications
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. BL60 is contraindicated in pregnancy. Needle GB20 toward the tip of the nose, not upward and medially toward the foramen magnum.
About
The textbook's prescription for headache located at the back of the head and neck, part of its scheme of choosing points by the channel that crosses the painful area.
Rationale
The occiput and nape belong to the Taiyang channels, so GB20 treats the area locally while BL60 on the foot and SI3 on the hand bring in the Foot- and Hand-Taiyang channels from a distance. Together they open the channels, harmonise qi and blood and ease 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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