Chronic Headache
Overview
Chronic headache occurs on ≥15 days/month for over 3 months; common forms are tension-type, chronic migraine, and medication-overuse headache, and it may also arise from cervical problems, hypertension, or sleep apnea. Chinese medicine calls it "head wind," distinguishing external contraction from internal injury, with patterns of ascendant liver yang, phlegm turbidity clouding the upper orifices, blood stasis blocking collaterals, and qi–blood deficiency. A new "thunderclap" severe headache or one with neurological signs requires emergency evaluation for secondary causes.
Pattern differentiation (clinical patterns)
Ascendant Liver Yang
Distending/pulsing headache with dizziness, red face and eyes, irritability, bitter mouth, poor sleep, red tongue yellow coating, wiry forceful pulse.
Level the liver and subdue yang.
Phlegm Turbidity Clouding the Upper Orifices
Muzzy heavy headache as if wrapped, chest/epigastric oppression, nausea, phlegmy saliva, white greasy coating, rolling pulse.
Strengthen the spleen and dry dampness; resolve phlegm and downbear counterflow.
Blood Stasis Blocking Collaterals
Long-standing fixed stabbing headache, dark complexion, dark tongue or stasis macules, rough pulse.
Invigorate blood and resolve stasis; unblock collaterals to stop pain.
Qi–Blood Deficiency
Dull headache that appears or worsens with exertion, dizziness, fatigue, dull complexion, palpitations, pale tongue, fine weak pulse.
Boost qi and nourish blood.
Connections
Daily care & prevention
Sleep and eat regularly, hydrate, and keep a headache diary (triggers, duration, medication); avoid frequent painkillers (no more than 10–15 days/month to prevent medication-overuse headache); do regular aerobic exercise, relaxation, and neck/shoulder stretching, and manage blood pressure. Massage Taiyang (EX-HN5), Yintang (EX-HN3), Baihui (GV20), Fengchi (GB20), Hegu (LI4), and Taichong (LR3). A change in headache pattern, morning headache with vomiting, neurological symptoms, or new headache after 50 warrants prompt evaluation.
When to seek medical care
A sudden "worst-ever" thunderclap headache, or headache with limb weakness/facial droop/speech difficulty/altered consciousness/seizure/high fever with stiff neck, worsening after head trauma, or severe headache in pregnancy/postpartum—seek emergency care immediately.