By Dr. Yoon Jeon. MChiro, MB, BSc, Dip.TCM, PGCert.
Case Presentation
A 27-year-old female teacher presented with a long-standing history of recurrent migraine headaches, which had been present since her late teenage years.
The patient reported episodic moderate to severe headaches, typically unilateral, pulsating in nature, and associated with nausea, light sensitivity, and functional impairment during attacks.
Episodes were becoming more disruptive to work and daily activities, with increasing frequency during periods of stress and fatigue.
Previous management included over-the-counter analgesics and prescribed medications, which provided only temporary or partial relief.
Clinical Presentation
The clinical picture was consistent with chronic migraine pattern, with features including:
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Recurrent unilateral headache episodes
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Moderate to severe intensity
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Associated nausea and light sensitivity
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Stress and fatigue as common triggers
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Functional limitation during episodes
No red flag neurological symptoms were reported.
Clinical Impression
The presentation was consistent with:
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Chronic migraine without aura (long-standing pattern)
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Stress and fatigue-related trigger pattern
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Possible autonomic dysregulation contributing to recurrence
From a Traditional Chinese Medicine (TCM) perspective, the pattern was consistent with a combination of:
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Liver Qi stagnation
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Liver Yang rising
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Underlying deficiency contributing to recurrent symptoms
Treatment
A structured integrative treatment approach was implemented:
Acupuncture for Migraine Management
Acupuncture was used to regulate autonomic nervous system function, reduce headache frequency, and improve stress response.
Treatment focused on:
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Reducing sympathetic overactivity
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Modulating pain perception pathways
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Improving systemic regulation of stress-related triggers
Herbal Medicine Prescription
An individualised herbal formula was prescribed to:
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Stabilise mood and stress response
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Support liver and digestive balance (TCM framework)
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Reduce frequency and intensity of migraine episodes
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Improve sleep quality and recovery
Clinical Outcome
After 2 weeks:
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Reduction in headache intensity
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Improved stress tolerance
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Early reduction in episode frequency
After 4–6 weeks:
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Significant reduction in migraine frequency
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Marked improvement in daily function
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Reduced reliance on pain medication
At follow-up:
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Patient reported near complete resolution of migraine episodes
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Occasional mild tension only during high stress periods
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No disabling migraine attacks reported
Discussion
Migraine is a complex neurovascular disorder involving central sensitisation, trigeminovascular activation, and autonomic dysregulation.
Evidence suggests that acupuncture may be effective in reducing migraine frequency and intensity through modulation of pain pathways and neurochemical regulation.
A systematic review by Linde Klaus et al. (Cochrane Review) found that acupuncture can reduce migraine frequency and is at least as effective as prophylactic medication in some patients.
Additional research by Zhao L has demonstrated that acupuncture may reduce migraine recurrence and improve quality of life.
Herbal medicine in traditional systems has also been used to regulate autonomic imbalance and stress-related triggers contributing to migraine patterns.
Conclusion
This case demonstrates that chronic migraine, even with a long history since adolescence, may respond positively to an integrative approach combining acupuncture and herbal medicine.
The treatment resulted in a significant reduction in migraine frequency, improved functional capacity, and reduction in medication dependence.
References
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Linde Klaus et al. (Cochrane Review). Acupuncture for migraine prophylaxis.
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Zhao L et al. Acupuncture for migraine: systematic review and meta-analysis.
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National Institute for Health and Care Excellence. Headache and migraine management guidelines.
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Caroline A Smith et al. Acupuncture for chronic pain and headache conditions.
