Migraine, also known as one-sided headache, is a common clinical condition. The characteristic of migraine onset is sudden and intense pain, usually on one side of the head (left or right), often presenting as throbbing, pulsating, or stabbing pain. This condition frequently recurs and persists over time, severely affecting patients' daily lives.
Among the twelve regular meridians, the Triple Energizer Meridian of Hand-Shaoyang and the Gallbladder Meridian of Foot-Shaoyang both run along the sides of the head and the ear. Therefore, in Traditional Chinese Medicine (TCM), migraine is referred to as Shaoyang headache. Based on the location of the migraine and the associated meridians, four acupoints—Sizhu Kong (TE23), Taiyang (EX-HN5), Waiguan (TE5), and Fengchi (GB20)—can be selected for rapid pain relief.
Migraine Etiology and Pathogenesis
According to TCM, the head is the “confluence of all yang meridians,” being at the highest point of the body, where the three yang meridians of the hand and the three yang meridians of the foot converge. It is also considered the “abode of clear yang” and the location of the sea of marrow, with the essence blood of the five zang organs and the pure yang qi of the six fu organs ascending to it. If the six pathogenic factors (wind, cold, summer-heat, dampness, dryness, and fire) invade the Shaoyang meridian and ascend to the temporal region, obstructing the clear yang; or if phlegm turbidity and blood stasis block the Shaoyang meridians, impeding the flow of qi; or if there is insufficient qi and blood in the Shaoyang meridian, leading to insufficient ascension of clear yang due to qi deficiency and malnourishment of the head due to blood deficiency, these can all cause migraines. Emotional fluctuations and excessive fatigue are common triggers for this condition. The nature of the pain is related to different etiologies and pathogeneses: distending pain is often due to stagnation caused by liver and gallbladder fire, pulsating pain is often due to hyperactivity of liver yang, and stabbing pain is often due to blood stasis and poor circulation.
Acupoint Regulation
Sizhu Kong (TE23) is an acupoint of the Triple Energizer Meridian of Hand-Shaoyang, located on the face, in the depression at the outer end of the eyebrow. Massaging this acupoint has the effect of regulating qi and relieving pain, reflecting both the principle of selecting local acupoints and the principle of selecting acupoints along the meridian in clinical acupuncture and moxibustion.
Waiguan (TE5) is a connecting acupoint of the Triple Energizer Meridian of Hand-Shaoyang and one of the eight confluent points, communicating with the Yang Wei Vessel. It is located on the posterior aspect of the forearm, 2 cun above the distal transverse crease of the wrist, in the midpoint between the ulna and the radius. Waiguan is effective for treating one-sided headaches, demonstrating the principle of selecting distal acupoints along the meridian.
Fengchi (GB20) is an acupoint of the Gallbladder Meridian of Foot-Shaoyang and the confluence point of the Foot-Shaoyang and Yang Wei Vessels, located at the nape of the neck, below the occipital bone, in the depression between the upper ends of the sternocleidomastoid muscle and the trapezius muscle. Fengchi is a crucial acupoint for expelling wind and is used to treat migraines caused by external wind pathogens, internal wind due to liver wind stirring, and hyperactivity of liver yang.
Taiyang (EX-HN5) is an extra acupoint, located in the temporal region, in the depression approximately one fingerbreadth behind the outer end of the eyebrow and the outer corner of the eye. For migraines characterized by stabbing or pulsating pain, pricking the Taiyang acupoint with a three-edged needle to induce bleeding can have an immediate effect.