Headaches are one of the most common chronic pain conditions; most people experience them at some point in their life.
What does recent research say about acupuncture treatment for headaches?
Acupuncture is commonly used to treat headaches and is recommended by the European Federation of Neurological Societies as a complimentary optional treatment.
According to the National Clinical Guideline Centre of the UK, 10 sessions of acupuncture are suggested for tension-type headaches and migraines when prophylactic medications are ineffective.
Research review suggested that acupuncture produced promising effects on tension-type headaches over standard care. Acupuncture effectively reduced pain intensity in acute migraines attacks.
Jaung-Geng Lin et al Am J Transl Res 2022;14(3):1469-1481
Types of headaches
Tension headaches are the most common form of headaches. Tension-type headaches can be either episodic or constant. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches. The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel have a tight band around the head. The shoulders and neck can also ache. Pain spread to or from the neck. Fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw can be a trigger of tension headaches.
Migraines occur less often than tension headaches, but they are usually much more severe. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is a pulsating, throbbing pain and it may be accompanied by blurred vision, light-headedness and nausea. A migraine can come on without warning, but about 20% of migraines begin with one or more neurological symptoms called an aura. Without effective treatment, migraine attacks usually last for a few hours to a few days.
Cluster headaches are uncommon but very severe headaches. The pain always strikes one side of the head typically located in or around one eye and is very severe burning or sharp pain. The affected area may become red and swollen, the eyelid may droop, and the nasal passage on the affected side may become stuffy and runny. The attack starts abruptly and lasts for 30 to 60 minutes. This type of headaches tends to come in clusters, with one to eight headaches a day during a period of weeks, months or a couple of years. In between clusters, there may be no headache symptoms, and this headache-free period can last months to years.
Muscles related to headahces
Muscles attached to the base of the skull and related to tension headaches
Trapezuis muscle is one of the largest superficial muscles at the back. It is originated from the base of the skull and extends down to the neck, the upper back until mid back and it is inserted to the shoulder blades. The function of the trapezius muscle is performed by three distinct regions: upper, middle and lower parts. They move the shoulder blades and support the arms; retracts the shoulder blades; rotates and depresses the shoulder blades. The muscle can become tight and stiff causing headache which is characterised as pain at the base of the skull, on the temples, on the face, jaw pain or pain behind the eyes.
Semispinalis captisis lies deep to the trapezius muscle. It is originated from the four to seven cervical vertebraes and the upper seven thoracic vertibraes and is inserted into the base of the occipital bone deep to the trapesius muscle. They extend the head and neck when both sides of the muscles contract and also they rotate and flex the head and neck when one side of the muscle contracts.
Deep muscles under the skull
At the base of the skull deeper than semispinalis captis there are five muscles which are rectus capitis posterior minor,rectus capitis posterior major, rectus capitis anterior, rectus capitis lateralis, obliquus capitis superior. They connected the skull to the neck. They contribute to the head and neck movements (extention, flexion, and rotation) and are also related to the cause of headaches.
Splenius capitis is originated from the spinous process of the seventh cervical vertebra and the first three thoracic vertebrae and is inserted into the mastoid process and the surface of the base of the skull. It draws the head backward, extending the neck and rotates the head to one side turning the face to the same side.
Longissimus capitis is originated from the lower four cervical and upper four thoracic vertibraes and is inserted into the posterior margin of the mastoid process. It extends the head and spine.
Corrugators and frontalis muscles on the forehead are two facial expression muscles. They tighten in response to emotional tension.
The temporal muscle (the temporalis) at the temple is a broad fan shaped muscle on each side of the head covering much of the temporal bone. It is one of the muscles involved in jaw movement and is the most powerful chewing muscle of the temporomandibular joint. You can see and feel the muscle contracting while the jaw is clenching and unclenching. The muscle is innervated by a branch of trigeminal nerve. This muscle reacts to mental stress by tightening and is involved in tension headaches.
Tightening these muscles builds up tension and leads to the onset of the headaches.
The occipitalis muscle (occipital belly) is a muscle covering at the back of the skull. It is a thin and quadrilateral form. It originates from the lateral two thirds of the superior nuchal line of the skull and the mastoid process and ends in the scalp. Trigger points present in this muscle can cause tension headaches.
Temple muscles and tension headaches
The temporal muscle is a broad fan shaped muscle on each side of the head covering much of the temporal bone. It is one of the muscles involved in jaw movement and is the most powerful chewing muscle of the temporomandibular joint. You can see and feel the muscle contracting while the jaw is clenching and unclenching. The muscle is innervated by a branch of trigeminal nerve. This muscle may also be involved in headaches. If trigger points are present in these muscles, they can cause pain in the side of the face in temple region and the pain can radiate to the face, eye brow, jaw, upper teeth, head and neck.