In Traditional Chinese Medicine (TCM), not all headaches are treated the same. The foundations of TCM (and the logic it uses to diagnose patients) are interested in identifying the location of the headache to effectively differentiate its source. According to TCM theory, each type/location of headache corresponds to a different meridian channel. Understanding which meridian/channel is affected helps TCM practitioners determine their herbal medicine and acupuncture treatment strategy.
The Differences
Vertex
When a patient experiences a headache at the top of the head, it typically indicates either Liver imbalances, Qi deficiency, or Blood deficiency. In TCM, the Liver channel is responsible for ensuring the smooth flow of Qi, storing the Blood, and regulating emotions. Someone with high stress levels is likely to experience a vertex headache.
Occipital
Pain in the back of the head correlates to the Urinary Bladder channel, which runs down the posterior side of the body. In acute conditions, these headaches tend to be related to Wind-Cold. In chronic conditions, these headaches may be related to chronic Kidney deficiencies (a complex relationship that would need its own blog post!), Qi/Blood stagnation and/or whiplash.
Frontal (Forehead)
Tension or pain in the forehead is associated with the Stomach channel, which starts at the second toe and runs all the way up the anterior-lateral side of the body to the face. Frontal head pain suggests Stomach imbalances, such as deficiency or excess and/or the presence of phlegm/dampness. A patient who frequently eats spicy, greasy meals may present with a frontal headache.
Behind the Eyes
The Liver channel opens into and manifests in the eyes. Pain behind the eyes is therefore related to Liver Blood deficiency and/or ascending Liver yang. Lack of sleep prevents the Liver Blood from nourishing the eyes, which can cause tension and pain.
Unilateral and Temporal
The Gallbladder channel runs along the outsides of the body from head to toe. The Gallbladder meridian has an internal/external relationship with the Liver meridian. Therefore, TCM Liver imbalance is taken into consideration when the Gallbladder meridian is impacted. Liver imbalances such as ascending Liver yang, Liver Fire, and Liver Wind are most commonly attributed to headaches that are located along the Gallbladder meridian.
The Whole Head
While less common in clinical practice, there is a chance that patients experience pain throughout their entire head. In acute conditions, this tends to be related to Wind-Cold conditions. Someone who spends too much time outside in Chicago during the wintertime may present with a whole-head headache. In chronic conditions, a whole-head headache is indicative of a chronic deficiency.
Fixed Point
If someone has an extremely specific point of pain in/on their head, it is understood as blood stasis within the local channel (area). This is most commonly seen when there is trauma to the head, neck and/or shoulders.
Some Key Distinctions
TCM Definition of Qi: There is no one word or phrase in English that can adequately capture the meaning of Qi, but perhaps we can think of Qi as “matter on the verge of becoming energy, or energy at the point of materializing” (as explained in The Web That Has No Weaver: Understanding Chinese Medicine by Ted J. Kaptchuk).
TCM Definition of Blood (or “Xue” in Chinese): While sometimes understood to be the same red fluid that we now know so much about in Western Medicine, the characteristics and functions of Blood in TCM are not synonymous with Western medicine. In TCM, circulation, nourishing and moistening are the major activities of Blood (as explained in The Web That Has No Weaver: Understanding Chinese Medicine by Ted J. Kaptchuk).
Note: Organ names are capitalized in TCM literature in order to differentiate functional energy systems from our Western understanding of the physical organs. A Liver imbalance in TCM does NOT suggest that there is a pathological medical issue with the liver from a Western standpoint.
Here is a list of TCM definitions from the World Health Organization (WHO).
