Headaches in TCM

In Traditional Chinese Medicine (TCM), headaches are not all treated the same—they are seen as a symptom of underlying disharmony rather than a disease on their own. The location, timing, nature of pain, and accompanying symptoms all help identify the root cause. Here’s a breakdown:

1. Liver Yang Rising / Liver Fire

• TCM reasoning: The Liver governs smooth flow of Qi and Blood. When Liver Yang rises too strongly (often from Yin deficiency or emotional stress), it “pushes upward,” causing headache.

• Typical signs:

  • Throbbing or pounding headache, often on temples or sides of the head

  • Irritability, anger, dizziness

  • Red eyes, tinnitus, insomnia

  • Sensitivity to noise/light

• Common causes: Stress, emotional tension, Yin deficiency, overwork

• TCM approach:

  • Calm the Liver, subdue Yang, nourish Yin

  • Herbs: Tian Ma (Gastrodia), Gou Teng (Uncaria), Chai Hu (Bupleurum)

  • Acupuncture: LI4, LR3, GB20, Taiyang

Headaches are not normal

2. Blood Deficiency

• TCM reasoning: If Blood is insufficient, it cannot nourish the head and eyes properly.

• Typical signs:

  • Dull, empty headache

  • Worse in the morning or after activity

  • Pale complexion, dry skin, insomnia, poor memory

• Common causes: Poor diet, blood loss, chronic illness

• TCM approach:

  • Nourish Blood and calm the mind

  • Herbs: Dang Gui, Shu Di Huang, Bai Shao

  • Acupuncture: SP6, ST36, DU20

3. Kidney Yin Deficiency / Yin Deficiency Headache

• TCM reasoning: Yin cools and anchors Yang. Without enough Yin, empty heat rises, creating headaches.

• Typical signs:

  • Dull or burning headache, worse in the afternoon/evening

  • Dry mouth/throat, night sweats

  • Restlessness or insomnia

• TCM approach:

  • Nourish Kidney/Liver Yin and cool empty heat

  • Herbs: Mai Men Dong, Bai He, Shu Di Huang

  • Acupuncture: KI3, SP6, LR3, GB20

4. Wind-Cold or Wind-Heat Invasion (External Causes)

• TCM reasoning: Headaches can be caused by external pathogens like cold or heat entering through the nose, scalp, or skin.

• Typical signs:

  • Wind-Cold: Tight, stiff headache, worse in cold, with chills, clear nasal discharge

  • Wind-Heat: Throbbing headache, fever, sore throat, yellow nasal discharge

• TCM approach:

  • Expel pathogenic Wind and restore normal Qi flow

  • Herbs: Fang Feng, Gao Ben (Wind-Cold); Ju Hua, Bo He (Wind-Heat)

  • Acupuncture: LI4, GB20, DU16, Taiyang

5. Dampness / Phlegm Obstruction

• TCM reasoning: Internal Dampness or Phlegm can “cloud” the head, causing pressure or heaviness.

• Typical signs:

  • Head feels heavy, foggy, or like a band around the head

  • Nausea, poor appetite, sluggish digestion

  • Worse in humid weather

• TCM approach:

  • Transform Dampness, move Qi, and clear the head

  • Herbs: Fu Ling, Ban Xia, Chen Pi

  • Acupuncture: ST8, LI4, ST36, SP9

Important TCM Principle:

• Headache location matters:

  • Temples → Liver/Gallbladder

  • Forehead → Stomach or Yangming

  • Top of the head → Qi or Kidney deficiency

  • Back of head → Wind-Cold, Kidney, or Liver Yang Rising

• Timing matters:

  • Morning headaches → Blood deficiency or Kidney Yin/Yang deficiency

  • Afternoon/evening headaches → Yin deficiency or Liver Yang Rising

  • Headaches worse with stress → Qi stagnation/Liver imbalance

TCM Headache Patterns – Detailed Guide

1. Liver Yang Rising / Liver Fire

Location: Temples / sides of the headTypical signs: Throbbing or pounding headache, irritability, red eyes, tinnitus, insomniaCommon causes: Stress, emotional tension, Yin deficiency, overworkTCM approach: Calm the Liver, subdue Yang, and nourish Yin

• Herbs: Tian Ma, Gou Teng, Chai Hu

• Acupuncture: LI4, LR3, GB20, Taiyang

2. Blood Deficiency

Location: Dull, generalized, often worse in the morningTypical signs: Dull headache, pale complexion, dry skin, insomnia, poor memoryCommon causes: Poor diet, blood loss, chronic illnessTCM approach: Nourish Blood and calm the mind

• Herbs: Dang Gui, Shu Di Huang, Bai Shao

• Acupuncture: SP6, ST36, DU20

3. Yin Deficiency

Location: Top of head, often in afternoon/eveningTypical signs: Dull or burning headache, dry mouth/throat, night sweats, restlessnessCommon causes: Long-term stress, chronic illness, lack of restTCM approach: Nourish Kidney and Liver Yin, cool empty heat

• Herbs: Mai Men Dong, Bai He, Shu Di Huang

• Acupuncture: KI3, SP6, LR3, GB20

4. Wind-Cold or Wind-Heat Invasion

Location: Back of head or generalTypical signs:

• Wind-Cold: tight, stiff headache, chills, clear nasal discharge

• Wind-Heat: throbbing headache, fever, sore throat, yellow nasal discharge

  
  

  Common causes: Exposure to external pathogens

  
  

  TCM approach: Expel Wind-Cold or Wind-Heat

• Herbs: Fang Feng, Gao Ben (Wind-Cold); Ju Hua, Bo He (Wind-Heat)

• Acupuncture: LI4, GB20, DU16, Taiyang

5. Dampness / Phlegm Obstruction

Location: Heavy, foggy, or band-like sensation around the headTypical signs: Head feels heavy or foggy, nausea, poor appetite, sluggish digestionCommon causes: Internal Dampness, poor diet, weak SpleenTCM approach: Transform Dampness, move Qi, and clear the head

• Herbs: Fu Ling, Ban Xia, Chen Pi

• Acupuncture: ST8, LI4, ST36, SP9

Notes:

• Headache location gives clues: Temples → Liver/Gallbladder; Forehead → Stomach; Top → Qi or Kidney deficiency; Back → Wind-Cold or Kidney/Liver Yang Rising

• Timing matters: Morning → Blood/Kidney deficiency; Afternoon/evening → Yin deficiency or Liver Yang rising

• Accompanying symptoms (like dizziness, eye redness, fatigue) help pinpoint the pattern.