Body, Chinese Medicine, Herbalism
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Introduction to Headache Differentiation

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To be honest, the main reason I’d rather have cramps is because there is something so elusive, so hard to pin down about headaches. Feverfew has been proven to help migraines, but I have known it to not work on some people. Laying down with a wet rag over their eyes help some people, but others feel the headache actually get worse when resting. When I got Lesley Tierra’s Healing with the Herbs of Life I became enamored with her chapter about headaches. Part of the mystery of headaches dissolved as I discovered that there are about twenty different types of headaches from a Chinese perspective. Consider the nature of the headache in combination with the temperament of the person.

Where is the headache located?

Temples (one side or both), top of the head, sides of the heads, behind the eyes, forehead, back of head, whole head, face.

How often does it occur?

Twice a year, twice a month, twice a week. Acute or chronic.

What is the nature of the pain?

Dull, sharp, heavy, stabbing, empty, pulling, stiff, changes from one sensation to another.

How is it related to your state of health or life style?

Menstrual cycle, sinus infection, addiction withdrawal, hypertension, stress, high cholesterol, holidays, during work, pregnancy and postpartum.

How is it related to your emotional state?

Frustrated, angry, after crying, worried about money, relationship problems, anxiety or fear.

When is it triggered? Is it worse or better during the following:

Eating in general, eating specific foods, resting, pressure, cold, heat, activity, lying down, daytime, damp weather, menstrual cycle.

Tierra recommends equal parts of Feverfew, Chamomile, Willow Bark, and Angelica, with the Feverfew as a general formula for acute headaches. An alternate formula is Rosemary, Poplar, Willow, Wintergreen and Angelica. A general formula from Simon Mills for nagging but mild headaches is Linden, Yarrow, Self-Heal, and Wood Betony. These help by dilating the blood vessels, stimulating blood circulation, and dulling the pain sensation. Sounds like a perfect cure-all until you consider that not all headaches are caused by constriction of the blood vessels. Mills explains:

“…most migraines are accompanied by vasoconstriction of blood vessels, a significant minority are not; sufferers of the former often obtain relief by applying hot packs to the head and are probably more suited to Feverfew than those of the latter.”

These “general formulas” can also be called generic. They help symptomatically, they are formulated for the condition, not the personal constitution. Here is just one example of headache differentiation for someone with Blood stagnation, who shows:

  • Headache fixed in one place
  • Intense, severe pain; stabbing and boring
  • Side of body, ribs, abdomen may be painful/sore
  • Dark tongue, purple
  • In women there might be painful periods with dark blood clots
  • Dark complexion

Equal parts of Corydalis, Motherwort, Salvia, Cyperus and Ligusticum is recommended by Tierra. In this formula, the Corydalis is an anodyne for severe pain and breaking up stagnant blood, Motherwort and Salvia stimulates blood circulation without being too warming and also soothes the nervous system, Cyperus addresses stagnant Qi, while Ligusticum moves both stagnant Qi and Blood that can cause the intense, stabbing pain. But even the twenty patterns of headaches can be generic when the focus is still on the condition, not the person.


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