Migraines can be divided into two categories: acute and chronic.

Acute migraines are often caused by common colds, such as exposure to wind, rain, or cold, or having a fan or air conditioner blow directly on the head for a period of time. If not treated or treated incorrectly, they may eventually become chronic.

Chronic migraines are usually caused by long-term fatigue, deficiency of essence and blood, emotional instability, liver fire, or excessive ministerial fire (see "What is "Excessive Internal Heat" (heatiness)?"). The regulation and distribution of ministerial fire are mainly managed by the gallbladder and triple energizer, whose meridians are primarily distributed on the sides of the body (Figures 1 and 2). These sides are naturally thinner and have less blood. If the body's essence and blood are insufficient, the muscles on the sides are the first to lack nourishment. Insufficient essence and blood can also easily trigger excessive fire. The combination of essence and blood deficiency and excessive fire causes the muscles throughout the body to feel as if they are being scorched by fire, leading to dryness and tightness over time. Patients often experience symptoms such as tightness, soreness, and pain in the head, neck, shoulders, back, and limbs, especially on the sides of the body. Try pinching the sides of your head, and you will find many painful spots. Upon closer examination, you may also find some tight, hard tendons close to the bone that are very painful when pressed. Alternatively, try chopping the sides of your upper and lower limbs with your hand, and you will notice that the sides are usually the most painful. These are signs that the muscles along the gallbladder and triple energizer meridians have become dry and withered.

Figure 1: Hand shaoyang triple energizer meridian

Figure 2: Foot shaoyang gallbladder meridian

Chronic migraines are prone to recurring attacks. Patients often experience migraines triggered by factors that further deplete essence and blood or provoke excessive fire, such as fatigue, staying up late, prolonged visual strain, depression, anger, and menstruation. Additionally, due to the decrease in essence and blood and the tightening of muscles, the body's resistance and regulatory abilities weaken, making it more susceptible to external wind-cold, which further deprives the muscles of nourishment and exacerbates the condition.

In treating migraines, the most commonly prescribed formula in TCM medicine is Tea-Blended Ligusticum Powder. However, this formula is only suitable for migraines caused by external contraction of wind-cold (acute and temporary). The formula contains mostly warm and drying herbs, and five out of its eight ingredients are contraindicated or should be avoided by those with yin deficiency or blood deficiency. Using this formula for chronic migraines is like drinking poison to quench thirst. While it may temporarily relieve headaches, it further depletes body fluids, leading to dry mouth and increased fire. The pain may decrease while taking the medicine but worsen when not, making this symptomatic treatment highly detrimental.

Modern medicine treats migraines by masking symptoms, prescribing muscle relaxants, painkillers, and antidepressants. These chemical drugs not only do not help the condition but also harm the liver and kidneys, prolonging the illness. Once the medication is stopped, the condition often rebounds with severe attacks, causing more harm than good.

Chronic migraines are "cultivated" over a long period, so treatment must focus on reducing excessive fire, replenishing deficiencies, relaxing tight muscles, and soothing nervous tension. This can be achieved through acupuncture, tuina, and Chinese medicinals. Initial acupuncture treatments can lead to significant improvement, often by more than 60-70%. However, for a complete cure, it is recommended to undergo acupuncture 2-3 times a week, combined with herbal medicine, for 1-2 months. Patients should also adjust their lifestyle, diet, and mood, engage in moderate exercise, avoid foods that increase internal heat, and prevent prolonged visual strain and overwork. Daily self-massage and tapping, especially along the gallbladder and triple energizer meridians on the sides of the body, are essential. It is recommended to spend 10 minutes daily chopping from the feet and hands to the head with the hand, paying extra attention to particularly stiff or sore areas. With such intensive treatment, significant improvement can be seen in a short time, and within a few weeks, migraines can be permanently bid farewell.