Chinese Medicine: Eight Causes of Headaches, Their Origins, and Treatment

By Teng Cheng Liang
Teng Cheng Liang
Teng Cheng Liang
Dr. Teng Cheng-Liang, is a Chinese and Western medicine practitioner with more than 20 years of professional medical experience. He is the Superintendent of Chi Teh Medical Clinic & Cheng-Liang Medical Clinic in Taipei, Taiwan. He graduated from the College of Medicine at Taipei Medical University and completed his Doctoral Degree in Traditional Chinese Medicine at the Nanjing University of Chinese Medicine.
August 31, 2022 Updated: August 31, 2022

Headache is a localized pain that occurs in the head, neck, or above the shoulder. Frequent headaches not only affect one’s life, relationships, and work but also have a chance of developing into depression. Dr. Teng Cheng Liang, director of the Cheng Liang Medical Clinic, suggests eight common causes of headaches, explains their sources, symptoms, and how Traditional Chinese Medicine (TCM) treats them.


Migraine is a chronic, recurrent headache that is often accompanied by various autonomic nervous system symptoms. Migraine attacks are usually unilateral, accompanied by pulsating sensations, and can last from 2 to 72 hours. Symptoms can include nausea, vomiting, photophobia, and sensitivity to sound. These accompanying symptoms can aggravate the pain of a migraine.

Clinical statistics show one-third of migraine patients can feel the start of symptoms, such as distorted vision, enhanced sensitivity to sound, light, and smell, and physical disturbance, followed by the onset of migraine.

Migraines occur more frequently in adolescents and young adults, and more often in women than in men. In some people, they are caused by high blood pressure.

Cluster Headache

This is a recurrent unilateral headache, involving stabbing pain behind one eye or in the temple. It may be accompanied by tearing, nasal congestion, pupil changes, or eyelid drooping.  Symptoms can last from a few minutes to several hours.

Cluster headaches tend to occur periodically and will resolve on their own after a time. The patients are almost always male: this type of headache rarely affects women.

Temporal Artery Vasculitis

This is a type of vasculitis or inflammation often occurring in the temporal and ophthalmic arteries. The cause of the disease is unknown, but current research has found it may be related to autoimmune disease.

The most common symptom of temporal artery vasculitis is recurrent headaches, usually in the temporal lobe. There can also be painful pressure on the temples, and blurred vision. If left untreated, temporal artery vasculitis can lead to blindness.

In addition to headaches, other symptoms include muscle pain, muscle weakness, weight loss, joint pain, and fever. The average age of onset for this disorder is about 75. More female patients experience this condition than males.

Toxic Substances

There are many chemical toxins that cause headaches, including carbon monoxide, lead, nitrate, and plasticizer. These substances can easily aggravate headaches.

Plasticizers are common hormone-disrupting chemicals, also known as endocrine disrupters. They are frequently found in fast-food packaging and may affect the food itself. They can directly interfere with the body’s hormonal balance and produce toxic reactions. Once the blood-brain barrier is broken, plasticizers can directly affect the brain, causing migraine, vomiting, dizziness, and other symptoms.

Tension Headache

Tension headaches are the most common type of headache.  These headaches are experienced as a tight ring of pain, more pronounced in the back of the head.

The pain from tension headaches is often treated today with antidepressants, heart rate reducers, muscle relaxants, and painkillers.

Brain Tumors

Although a headache seldom indicates a brain tumor, if a brain tumor is present, headache is the most common symptom. The tumor compresses the brain tissue and causes edema or swelling. In turn, this increases intracranial pressure and leads to headaches. It is usually persistent or progressive and becomes more pronounced after waking up.

With brain tumor headache, the pain is on the side where the tumor grows. But as the intracranial pressure increases, the headache becomes more pronounced and more widespread.

If the tumor continues to grow, it may cause vomiting, blurred vision, and spasms or convulsions. If the tumor is located in the prefrontal lobe, it may cause personality changes; in the temporal lobe, it may cause memory or speech impairment; in the cerebellum, it may cause gait instability and movement disorders; in the motor nerve, it may cause weakness in the contralateral limb; and in the auditory nerve, it may cause loss of hearing or tinnitus.


Patients with meningitis experience fever, headache, stiff neck, and altered consciousness. Headache is caused by inflammation of the brain and elevated pressure, usually in the occipital or back of the head area. It is accompanied by nausea and vomiting and can worsen upon awakening.

The common pathogens that cause meningitis are pneumococcus, meningococcus, staphylococcus aureus, and viruses such as coxsackie, enterovirus, herpes, and Japanese encephalitis virus. Tuberculosis, mycobacteria, and syphilis may also cause meningitis.

When a person with meningitis has altered consciousness, confusion, speech impairment, and physical weakness, this indicates a brain infection and is called “encephalitis.”

Head Trauma

Headache caused by trauma usually occurs a few hours or days after the head was injured. About 30 percent of head trauma patients continue to have headaches after two months. This is referred to as a “post-concussion headache.”

Many head trauma cases are due to car accidents, and these headaches are typically felt throughout the head and even the neck. The pain is experienced as throbbing, constricting, squeezing, stabbing, or swelling in nature.

Some trauma headaches are so severe they can lead to incapacitation. In addition to headaches, head trauma can cause personality changes, memory impairment, inability to concentrate, distractibility, fatigue, sleep disorders, dizziness, irritability, depression, and frustration.

Conventional pain relief treatments include antidepressants, antiepileptic drugs, and, in severe cases, opioid medications. However, it is best to use painkillers sparingly because they may cause rebound headaches—headaches that become more pronounced due to frequent use of painkillers.

Chinese Medicine Treatment for Headache

In Chinese medicine, it is believed that climate changes such as wind, cold, heat, dampness, dryness, and fire, can help things grow in nature. But if climate change is abnormal and the human body resistance is low, it can become a cause of disease, called “the six excesses causing illness,” namely: excessive wind, cold, heat, dampness, dryness, and fire.

These are considered external causes of illness. The internal causes include energy deficiency of the human body, emotions, excessive fatigue, and other factors.

External and Internal Wind, Cold, Fire

Traditional Chinese medicine looks at humanity as a part of nature. It is believed that the energies that arise outside the body such as wind, cold, and fire, can arise inside the body as well, and affect the proper functioning of specific organs. If not treated, they can cause headaches and other ailments. For total health, Chinese medicine treats these energies by dispersing them so the organs heal and work together in a harmonious manner.

Here are some specific headache symptoms and how traditional Chinese medicine would treat them:

Headache with cold symptoms: Headaches are frequently associated with the common cold. Cold symptoms such as sneezing, runny nose, nasal congestion, and coughing may be caused or aggravated by external wind and cold. Using TCM, to properly treat these symptoms, internal wind and cold must be dispersed.  Recommended herbs:  peppermint, Divaricate Saposhnikovia (fangfeng), Manchurian Wildginger (Xixin), Incised Notopterygium rhizome and root (qianghuo), Taiwan Angelica root (Baizhi), and Szechwan lovage rhizome (chuanxiong).

Headache with irritability, poor sleep:  This suggests that liver fire (the counterpart of external fire, but involving the hepatitic system) is very strong. Treatment for this involves calming the liver fire. Recommended herbs: Sharpleaf Uncaria stem with hools (gouteng), Sea-ear Shell (shijueming), gardenia (zhizi), and Baikal Skullcap root (huangqin).

Headache with mental fatigue, poor color, and facial appearance:  This suggests a problem with blood circulation to the head. In this case, the treatment involves using herbs to nourish the blood and calm the liver wind. Recommended herbs:  Chinese Angelica, Dried Rehmannia root (shengdi), Tuber Fleeceflower root (HeShouWu), Szechwan Lovage rhizome (Chuanxiong), and chrysanthemum.

Headache with digestive problems:  Chinese medicine also treats digestive problems resulting from the stomach and spleen. These two organs should work collaboratively. The health of the spleen and stomach are vulnerable to the consumption of excessive alcohol, and sweet and fatty foods. Dizziness, nausea, loss of appetite, and loose stools all suggest a spleen deficiency. Recommended herbs: Tall Gastrodiae (Tianma), Largehead Atractylodes rhizome (Baishu), and Ternate Pinellia (Banxia).

Headache accompanied by lower back pain, knee weakness:  This indicates that the kidneys may be deficient, which can lead to headaches and forgetfulness. Treatment involves renourishing the kidney and liver and replenishing the kidney essence. Recommended herbs: Rehmannia, wolfberry, Chinese privet, and eucommia.

Headache due to trauma:  May be chronic and throbbing, and patients will often have suffered head trauma. The patient’s tongue will often have a purple spot at the tip. This type of headache can be relieved by improving blood circulation. Recommended herbs: peach kernel, red peony, motherwort, and Manchurian Wildginger (Xixin).

Most headaches can also be treated with acupuncture, targeting various pressure points. Of course, the simplest treatment for headaches arising from harmful toxins is to stay away from poisonous substances.  However, excluding headaches caused by brain tumors, Chinese medicine has for centuries proven effective in treating nearly every type of headache with select herbs and acupuncture.