Headaches are incredibly common - in fact, migraine and tension-type headaches are the second and third most common disorders worldwide.
Modern medicine has relatively little to offer, which helps explain why I’ve seen both the above conditions in my practice over the last two weeks.
The herbal approach to treatment is, as always, a holistic one, including diet and lifestyle assessment as well as herbal medicine. In this article, I’ll focus mostly on the herbs.
Let’s deal with each type of headache separately.
Migraine headaches
Women suffer twice as much as men from this debilitating illness, and a surprising 90% of sufferers have a family history of migraine attacks.
In character, migraines are commonly unilateral (on one side), severe, throbbing or pulsatile, and last 4-72 hours. An ‘aura’ or ‘prodrome’ may accompany or precede the attack, and symptoms may include nausea, sensitivity to light or sound, or vomiting.
Routine treatment involves avoiding personal triggers - certain foods, weather changes, bright lights - and addressing stress and hormonal balance (in women). The Pill and Mirena coil can cause migraine and non-migraine headaches - an important thing for women to be aware of.
Researchers have also come up with a few other things - firstly, the brains of people with migraines may have a problem with energy generation due to faulty ‘mitochondria’ at a cellular level.
Magnesium, vitamin B2 (riboflavin) and CoQ10 all help with mitochondrial energy production, as do the herbs gotu kola (Centella asiatica), hawthorn (Crataegus laevigata), barberry (Berberis vulgaris), turmeric (Curcuma longa) and green tea (Camellia sinensis).
The Pill and Mirena coil can cause migraine and non-migraine headaches.
Next is the link to an increasingly common gene mutation (MTHFR C677T) for the gene that processes folate into a usable form in the body. People with this mutation may have other symptoms of digestive, hormonal, cardiovascular, autoimmune or psychiatric disorders.
In this case, taking pre-methylated forms of vitamin B6, B12 and folic acid can really help, along with the herb milk thistle (Silybum marianum) to aid in liver detoxification.
Feverfew, or Tanacetum parthenium, is the only herb that has been properly researched as a migraine preventative. In a double-blind, placebo-controlled study, daily use of dried feverfew leaves reduced the average number and severity of migraines with no notable side-effects.
Historically, it has been used for pain in highly sensitive people, for rheumatic complaints as well as earache and headache. It acts as an anti-inflammatory and helps to dilate blood vessels in the head, encouraging circulation and preventing blood clotting. For this reason it's best avoided in combination with blood thinning medications.
The fresh leaf is considered the most effective - take 2 or 3 per day as a migraine preventative, with some fat (butter or coconut oil) to help the components pass the blood brain barrier. I give my patients a fresh tincture of the herb, which also works well.
Feverfew acts as an anti-inflammatory and helps to dilate blood vessels in the head, encouraging circulation.
For pre-menstrual migraines there is some evidence for the use of Chasteberry (Vitex-agnus castus) to reduce the frequency and duration of attacks, while oestrogenic herbs such as Shatavari (Asparagus racemosus) are traditionally used for migraines that occur during menstruation.
Tension headaches
These kind of headaches - typically frontal, bilateral (on both sides), and of a ‘pressing’ or ‘tightening’ quality - are more simply attributed to stress. The pain is less severe than migraines but can last longer - up to a week.
They can be more muscular in origin, related to tension in the neck and shoulders, in which case anti-spasmodic and relaxant herbs like cramp bark (Viburnum opulus) and Jamaican dogwood (Piscidia erythrina) work wonders.
Researchers have also discovered a link between chronic tension headache and low cortisol levels due to long-term chronic stress. This is another area where herbs can really shine - adaptogens like ashwagandha (Withania somnifera) and rhodiola (Rhodiola rosea) modulate the stress response and calm the nervous system, and liquorice (Glycyrrhiza glabra) prolongs the breakdown of cortisol in the body, helping to sustain adequate levels.
Researchers have discovered a link between chronic tension headache and low cortisol levels.
Nourishing lifestyle practices like yoga & meditation really help with tension headaches, as with migraines. Avoiding over-the-counter painkillers like ibuprofen and paracetamol is also important, as reaching for these too often can in fact cause the headaches to recur.
Other headaches
Other types of headaches include a high blood pressure headache - a throbbing type of headache that responds to herbal & dietary approaches to lower blood pressure - and cluster headaches, which are notoriously painful and elusive.
In cases of cluster headache it is always necessary to rule out serious pathology of the head before treating with strong nervines and pain-relieving herbs, such as yellow jasmine (Gelsemium sempervirens).
Pain is a symptom - a warning that something isn’t right in the body - and headaches are no different. In my practice I help people use their symptoms to dig deeper and find out the root cause, cultivating better body awareness and overall health along the way.