Case Studies: Natural Migraine Relief

By Christopher Hobbs, L.Ac. and A.H.G.
Published on July 1, 2001
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Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism

Recipe:Headache Tea

Nearly everyone has a headache at one time or another. Headaches are the most common cause of missing work and, besides fatigue, the most common reason for visiting a physician. One writer on headaches said: “Millions drag themselves to work only to endure another day of decreased productivity.” An estimated 40 million to 50 million Americans experience chronic headaches severe enough to disrupt their lives. Science has increasingly identified the major mechanism of migraines and tension headaches–the trigeminal nerve (fifth cranial nerve), responsible for sensory and motor functions in the face, teeth, mouth, and nasal cavity. Headaches are believed to be triggered by pro-inflammatory substances released by the immune system due to an allergic reaction or autoimmune reaction. Certain neurotransmitters such as serotonin might also play a role.

Karen’s case

Karen was experiencing a headache when she came into my clinic. Her brow was furled, and she had a look of anguish in her eyes. I began treating her with some simple headache relievers that I have found successful. The main headache acupuncture point in the body is between the thumb and first finger near the middle of the fleshy part of the web. Applying steady or intermittent pressure to a spot you can find that is especially sensitive–even painful–for a few minutes can quickly ease some kinds of headaches, especially tension headaches or headaches due to digestive or liver imbalances. Because liver tension and hyperactivity due to stress, drugs, alcohol, and other factors is nearly always associated with headaches in Traditional Chinese Medicine (TCM), I also pressed on the tender spot on the top of the foot between the big toe and first toe, right above where the bones come together to form a fork. This spot is a major liver-release point and can often ease a headache due to liver imbalances. The two points together are called “four gates” and are among the most popular acupuncture prescriptions for many kinds of headaches and liver problems.

I inserted needles into these two points and then began to rub a little St. John’s wort (Hypericum perforatum) oil (with a small amount of lavender essential oil added) into the other popular headache point, the “tai yang,” at the temples. I also rubbed a little oil into the occiput–the tender spots in the hollows on the right and left under the bony ridge at the back of the skull. These are the best spots to push and work for five to ten minutes for tension headaches that start at or affect the back of the head. These are wonderful spots for releasing headaches in general, especially if you can identify a very tender and sensitive point on each side, which actually make the headache a little worse at first when they are pushed.

After ten minutes, Karen told me the headache was easing up, and after twenty minutes, it was nearly gone. For more than ten years, I have noticed that acupuncture, herbal oils applied with pressure or circular movements over trigger points, and herbal remedies are among the most effective methods for easing various kinds of headaches.

Migraine headaches

Karen told me she had been a migraine sufferer for more than twenty years and had frequent tension headaches as well. Migraines are severe headaches where predictable criteria can be observed, according to the International Headache Society. Migraines can occur with or without prior nervous system activation. Symptoms can include an aura, which consists of visual or other disturbances that precede head pain. Migraine sufferers may see flashing lights, bright spots, or have blurry vision; weakness or slurred speech can also occur as part of the aura, but less commonly. Guidelines for migraines without aura include “at least five attacks lasting four to seventy-two hours with at least two of the following: one-sided, pulsating feeling, intensity is such that the headache interferes with daily activities, and physical activity usually worsens the headache.” Because the biochemical mechanisms for migraines and tension headaches are the same, Western herbal medicine and TCM do not usually prescribe different treatments for each type. Diagnosis is still based on individual differences, signs, and symptoms.

Karen had already tried the common over-the-counter remedies such as aspirin and ibuprofen. These are sometimes helpful for immediate relief of a really painful headache, but usually not helpful for migraines. These medications are okay for occasional use, but prolonged and frequent use can actually have a rebound effect, increasing the severity of the headaches between doses. Many of them have a notably stressful effect on the liver and kidneys.

The liver connection

As I’ve written many times before in this column, a common symptom such as a headache can be due to imbalances in different body systems or organs, so it is important to determine–based on one’s history, signs, and symptoms–the most affected organs in order to reveal the underlying causes of any symptom.

The sides of Karen’s tongue were “peeled” and very red. This let me know that her liver was chronically hyperactive and overheated. She also told me that her headaches tended to occur more on the sides of the head and temples rather than the back of her head. This kind of “livery” headache went along with other symptoms she had experienced in the prior few months, such as menstrual irregularity, irritability, and digestive troubles, especially with fatty foods.

Based on this, I wrote out a complete program for Karen to ease her liver tension and reduce heat. She also agreed to try an herbal formula to ease symptoms for immediate use instead of the over-the-counter medications she normally used. The prescription for easing her liver hyperactivity was as follows: 30 percent burdock root (Arctium lappa), 20 percent each artichoke leaf (Cynara scolymus), Oregon grape root (Mahonia aquifolium), and ligustrum (Ligustrum spp.), and 10 percent yellow dock root (Rumex crispus).

Herbal headache formulas

The formula for relieving acute headaches contained 40 percent meadowsweet (Filipendula ulmaria), 30 percent wood betony (Stachys officinalis), 20 percent passionflower (Passiflora incarnata), and 10 percent rosemary (Rosmarinus officinalis). I gave her a blend of these herbs in tincture form and recommended that she take 1 teaspoon of the liquid in a little water several times daily, or as needed.

Additionally, I recommended she take standardized willow bark (Salix spp.) in tablet form instead of aspirin. I have seen good results for headaches, and willow bark does not have side effects.

Karen told me that she was a big fan of herbal tea, so I went to the pharmacy and blended up this herbal tea formula for easing headaches to use with the tincture.

Satisfying results

Karen continued to come in for acupuncture, and I trained her to work on the trigger points on her hands, head, and feet. These proved to be a big help, sometimes aborting a headache before it got established, and sometimes reducing its severity.

Although the herbal remedies are often slower-acting and don’t offer the same kind of immediate relief that more toxic drugs do, Karen told me that after a few months of use, they offered noticeable benefits. Her headaches came much less frequently and were less severe. This translated into less disruption in her work and family life.


Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is the creator of the new correspondence course Foundations of Herbalism. Visit his website at www.christopherhobbs.com.

“Case studies” is not intended to replace the advice of your health-care provider.

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