The most common reason for headache is the narrowing of blood vessels. Master Nagano says that the blood vessels get tight from stress, causing what we commonly call “stress headache.” This results in too much CO2 and not enough oxygen in the body. Regardless of the nature of the headache you can always use the Ba Feng points (the extra points in the webs of the feet), as these open up the blood vessels to the head and neck. These are Nagano’s “essential depression point” and are used for headaches, depression, post-stroke, and brain damage (the depression here refers to “mild depression” where the patient is not on heavy medication). Since healing always requires oxygen, one cannot go wrong by using the Ba Feng point, they can only aid healing by activating circulation and oxygenating the head/brain.

If the pulse is very weak, this confirms the possibility of vessel constriction. Your first mode of attack would be to strengthen the pulse by using Sp 6, Sp 9, and Pericardium. Check P 8 (Fire point). If it is painful, use P 3 + P 5 (Metal/Water). If the patient likes the pressure on P 8, needle it, however, if the patient likes the pressure but dislikes the idea of a needle in P 8, needle P 4 instead (our P 4 is 3 fingers below P 3!). If the patient does not care about the pressure on P 8 either way, needle P 6.

For any headache check the Hua Tuo of T2, T3, T4, for weird, gummy or squeezed-together vertebra feeling, and needle it, breaking down the gummy and separating the vertebrae. This area, that is prone to kyphosis in the elderly, can block circulation to the head (this is why this area is so important in all facial problems, including eyes). If you find two vertebrae that are squeezed together, chances are that you will find a widened space above or below. Needle the narrower space (squeezed-together feeling space) 45o towards the spine, and moxa on the Du line where there is a wider space.

Always check the scalenes in patients complaining of headaches. Again, this is because the scalenes reflect the brachio-radial plexus that is involved in blood circulation to the trapezius, neck and head. Press the scalenes (St 11 area) with the flat part of your fingers, not pressing too hard or too pointedly. If the patient complains of pain or you feel a tightness or a ropy feeling, release the scalenes by use of Sp 3.2, Lu 8, or H 3 (any of these, or a combination). Sp 3.2 is slightly proxymal to Sp 3, in the direction of SP4. HT3 is taken at the edge of the elbow crease (making it slightly more lateral than the TCM location that is closer to the bone) and is needled at a 10o angle in the direction of the meridian flow.

For any type of headache consider the role of blood pressure, low, high, or “weird” (we consider weird ratio between cystolic and diastolic to indicate a blood pressure problem: ideally the difference should be around 40). These might reflect as gummyness, or even puffyness in severe cases, in the occipital region. Use the points under the 3rd toe (where the tow meets the ball of the foot – the phalangeal-tarsal joint), with Sp 6, Sp 9 and Pericardium (as per above). On the back treat the gummy areas between SI 9 and SI 10, needing these points up and out.

Finally, for any kind of headache, you may need to release the SCM and/or the trapezius. Check the SCM with the flat part of your fingers. Check the whole length of the SCM. Release the SCM with the opposite ~SJ 8 and GB 40 (both on the opposite side). The point we call “~SJ 8” is about one third down from the elbow to the wrist on the Triple Warmer channel, at the mound of the muscle: you must find the exact spot that releases the opposite side SCM. Trapezius tightness may show in the neck as well as in the shoulder. If it shows at the neck level, close to the cervicals, it can be released with the opposite ~SJ 8/GB 40 combination with the addition of GB 26 (same side as the neck tension). Trapezius pain/tightness at the shoulder level is released by use of Inner Yin, a point on the Kidney channel that is level with Liv 9 (or 5 fingers above K 10).

Once these are checked, we can also analyse headaches by their location, similar to the manner by which TCM categorises headaches.

Occipital Headache:

This can be a result of the following:
• C1 (Atlas) shift. This reflects on the Mastoid bone and is treated via Liv13.
• Blood pressure. This is treated via Under-3rd-Toe, Sp 6, Sp 9, Pericardium.
• Circulation problems (very thin pulse). Treated via Sp 6, Sp 9, Pericardium.
• Cardiac problems. This is a vast subject: generally cardiac issues reflect on left SI 11, and/or the inner border of the left scapula. The gummyness on the left scapula must be resolved. For Rapid pulse treat Ren4, for slow pulse treat UB 27. Then you can moxa the gummy areas on the left scapula.
• Hormonal issues. Treat SI 3, UB 2, SI 13.
• Head injuries. If the injury is in the Tai Yang zone, treat Ihikun (UB 58, UB 40, UB 60 – it is important to find the exact spot for UB 58 which may be above its text book location. UB 40 is taken quite close to UB 39, that is on the lateral side of the popliteal fossa). For injury on the Shao Yang zone, check the SCM and treat opposite side ~SJ 8 + GB 40 (or SJ 5 + GB 41 if the pulse is rapid). Because many head injuries involve more than one zone, it is common to treat both combinations.
• Eyesight problems. Treat UB 2 or Yu Yao, and treat the eye problem thoroughly.
• Teeth/TMJ problems. This affect the postural musculature in the occiput. For TMJ, treat K 6, K 27 (Adrenal treatment), and a point behind GB 21 (the point which releases the TMJ. For teeth/gum problems, add UB 11 (meeting point of bones).
• Menopause (DU 20 and UB 2 are also common pain areas in menopause). Treat K 7, K 27, with the possible addition of SI 3.

Temporal Headache:

For temporal headache, use the Tai Yang point, or an area close to it as a reflex for the headache. If your treatment releases the pressure pain on the Tai Yang point, it is likely to be affecting the headache. Several treatment possibilities are as follows:
• TMJ related. Treat K 6, K 27 (Adrenal treatment) and the point behind GB 21 (this point should release the jaw). Then tape Kawai’s rings on the painful spot on the jaw (a minimum of 20 minutes).
• The Shao Yang/SCM type. Treat via opposite side ~SJ 8 and GB 40. If the pulse is rapid, SJ 5 and GB 41 (both on the opposite side to the headache) is the preferred combination, however, choose the points by confirming their effect on the SCM and the Tai Yang point on the opposite side.
• Weak and thin pulse. Treat Sp 6, Sp 9, Pericardium.
• Naso-pharyngitis infections. Treat the Immune points (LI 10-11 on the edge of the bone, close to the Triple Warmer channel). Tape Kawai’s rings on LI 20/BiTong area.

Frontal headache:

This is most commonly related to sinus problem: allergies, infections, etc. Find the sore spot around LI 20, St 3 area and use it as a reflex. (Although the sinus pain can be above the eyes, one should use points below the eyes as reflexes of the sinuses.) Treat with the Immune points (with moxa). Check the Fire points of Yang Ming (LI 5 and St 41), and, if painful, treat the corresponding Metal/Water points (LI 1, LI 2, or St 44, St 45). Because the L.I. channel crosses over to the opposite side, the opposite LI 1/LI 2 (resolving their own side Fire point) can sometimes release sinus pressure, or it can be same side.

Vertex headache:

This type headache can be related to stress (insomnia, irritability), to hormonal problems (as in menopause), or to an injury/trauma to the Lower Dan Tian.
• If it is related to stress, insomnia, etc., check Ren17 and Ren15 as Anxiety and Insomnia reflexes. Ren15 pressure pain (that is not related to cardiac) can be resolved through Sp 3.2 and P 4 (3 fingers below P 3). Pressure pain on Ren17 can be alleviated by SJ 5 and GB 41 (bilaterally), and then the use of a Pericardium point (determine which point by poking P 8 as per above).
• A disruption to the Lower Dan Tian will move up to the Middle Dan Tian (Ren17), and then the Upper Dan Tian (DU20 area). One sees this commonly in post-partum depression where a C-section, or hard labour, disrupted the Lower Dan Tian and resulted in symptoms in the head, showing as pressure pain on DU20 and the vicinity (Si Shen Cong). Treat this with Sp 6, Sp 9, Lu 5, and Pericardium (determine the points by Fire point, P 8, diagnosis).
• DU20 headaches that are related to hormonal issues can be treated via Sp 6 and P 6. When gynecological issues are involved, Lu 7 often does a better job than P 6.
• Generally Sp 6 has an effect on DU20, as does the chin (check for scars under the chin, and if you find pain, see if that releases DU20 area.

Eye pain:

UB 2 area pain is considered to be a hormonal headache. Use any of Liv 2, H 3, or UB 59 (UB 59 is needled against the channel), singly or in combination.

Deep eye pain, often accompanies a wiry pulse (a wiry pulse by Master Nagano might be described in TCM as an aggressive slippery/wiry pulse – the main feature of this pulse is that it does not loose strength nor its quality when it is pressed deeply). In this case use GB 39 (needled against the channel with a slightly thicker needle, #3 or #5) and Sp 9 and/or Sp 10. This is considered Wood G.B. invading Spleen Earth. This type of pulse is common in Parkinson’s disease patients, stroke, and even Bell’s palsy. When this pulse is felt, the recommended treatment is dispersing GB 39 and tonifying the Spleen.

For pain behind the eye, use Liv 9 (about one third from the knee to the groin – sometimes another point two thirds up the thigh is also useful: these are Hashimoto’s Liver Eye points).

Whole head headache:

Aside from lack of oxygen (treat the Ba Feng points), this is most commonly an issue of sympathetic dominance with a tight pulse (tight pulse by Master Nagano can be described in TCM terms as a thin and wiry pulse that looses this quality upon deep palpation – it either changes quality or disappears). If the pulse is rapid, treat SJ 3: for men, treat on the left, for women, treat on the right. Also use Ren12, Ren15, needled 30o upwards, with Ren6. If the pulse is slow, use the Liao points (UB 31 through UB 34).

Dizziness:

The most common causes of dizziness are low blood pressure, liver deficiency, ear problems, and T4/T5 shift.