In this post, I will discuss how to treat occipital headaches using traditional acupuncture points, ear points, and Master Tung's points. I will also talk about how myofascial lines and the craniosacral system relate to treating this condition. Understanding traditional approaches, and integrating the knowledge of myofascial lines and the neurology of the craniosacral system, allows the clinician to make better point selections for more effective results.
Frequently Used Points
In TCM, the acupuncture points SI 3, UB 10, UB 60, and GB 20 are some of the more frequently used points for occipital headaches. In the Master Tung system, points used include SI 3, LI 3, points on the Achilles tendon, fingers, sacrum, face, and on the bladder meridian from the mid-thigh to the middle of the lower leg. We will discuss these various point groups in more detail below.
Small Intestine 3 is used in both TCM and Tung style acupuncture, but in the Tung system it is used with another point 1.5 cun proximal which is numbered 22.09. You can see the points in the above image of the hand. The points on the SI meridian are also located on the Deep Back Arm Line (DBAL) and can affect the levator scapulae muscle which attaches to the upper cervical vertebrae. This myofascial relationship likely plays a role in SI 3 being able to treat neck and occipital pain.
Another common point group for occipital headaches and neck pain in the Tung system are the points on the Achilles tendon. These points are numbered 77.01, 77.02, and 77.03, and should be needled as a set to get optimum results. Needling the SI points on the hand with the points on the Achilles tendon targets the tai yang meridians and is an effective method for many cases of occipital pain.
Another group on the hand used in the Master Tung system includes a set of three points on the middle finger called the Three Finger Spine points. These may be used instead of SI 3 and 22.09 and can be effective when neurological pathologies are present. Similarly, the points shown in blue include Ling Gu, Da Bai, and Fan Hou Jue, and this point group is especially effective when pain is also present in the trapezius, forehead, and sinuses.
With so many point groups to choose from for treating occipital headaches, it can be confusing knowing what point groups to select for each patient. While some point groups work great for one patient, they may not effectively treat another patient with similar symptoms. However, if we consider how various points affect not only meridians, but also myofascial lines, muscles, fascia, and other tissues, we can gain greater insight into how to better use different point groups.
Urinary Bladder Points for Treating Occipital Headaches
Lending insight into how myofascial lines contribute to therapeutic effects, we find three major point groups on the UB meridian in the Tung system that are used for occipital headaches. These include the points in the Achilles tendon (77.01 - 77.03), points from the mid-thigh down to the middle of the lower leg, and points in the sacrum. In the image below the regions in blue represent major areas where points may be used.
An effective method to treat many patterns of occipital headaches is to use SI 3 and 22.09 contralateral to the pain. These should also be paired with one of the point groups pictured above and on the urinary bladder meridian. From a meridian-based perspective, and according to traditional theories about treating the opposite end of a meridian for therapeutic results, we can understand how points in the sacrum, hamstrings, legs, and Achilles tendon can treat the occiput. Similarly, a myofascial perspective allows us to comprehend how these points can treat the occiput via the transmission of mechanical forces, micro-stretching, and changes in connective tissue proteins that occur within and through the fascia.
When points are inserted into the Achilles tendon, hamstrings, and lower legs, it can also affect the sacral region via the sacral myotomes. The nerves that emerge from the sacrum innervate the skin and muscles that follow the course of the UB meridian in the leg. This may contribute to craniosacral system responses and allows for a neurological perspective for why these points on the UB meridian are so effective for pain in the occipital region.
Ear Points and Cervicogenic Occipital Headaches
Occipital headaches may result from problems originating in the cervical vertebrae. When this is the case, it is often helpful to add ear points that can target the cervical nerves. In the traditional ear mapping system the inferior portion of the anti-helix is associated with the cervical vertebrae. In my experience, I also find that points in the inferior portion of the scapha can also be effective for neck pain. These points can be seen as red dots in the image below.
Neurologically, the points in red and the anti-helix, scapha, and in the green section of the ear are innervated by the great auricular nerve. The nerve emerges from C2 - C3, so by needling these points we can affect the vertebrae from C1 - C4. Including these points in a prescription can be incredibly effective for occipital headaches resulting from pathologies in the upper cervical vertebrae.
In addition to the red points in the above image, the white points are the five points used in the Battlefield Acupuncture point protocol. The founder of this system Dr. Richard Niemtzow M.D., PhD, Colonial USAF, states in his article Battlefield Acupuncture that the upper three points including Point Zero, Ear Shen Men, and Omega 2 can be used for treating migraines. One possible mechanism for these points' ability to treat migraines is via the trigeminal nerve which is the fifth cranial nerve.
In the image above of the ear, we see that Ear Shen Men and Omega 2 are both located in the area innervated by the auriculotemporal branch of the trigeminal nerve. Therefore, needling these two points will elicit neurological responses in the trigeminal nerve and structures such as the thalamus with which it has connections. Since pathologies affecting the trigeminal nerve are involved in migraines, ear acupuncture in this region provides a stimulus that can provide pain relief when properly needled.
Summary
While traditional acupuncture methods are often effective for occipital headaches, it is not always easy to determine what points will produce the best results for each patient. What works well for one patient may not produce a result for the next one. When traditional teachings are integrated with modern findings from myofascial anatomy and neurology, it fills in many of the gaps that can be left with traditional theories and methods. Similarly, a neurological perspective on acupuncture cannot explain all of the actions of points and their uses. However, when a myofascial model is adopted and integrated with traditional theories and neurology, it can complement and fill our current voids in understanding why the points work the way they do.
To learn more watch the video below from my soon-to-be-released class Acupuncture and the Craniosacral System.