**3. The use of acupoints as a therapy for headache**

**2. Basic concept of traditional Oriental medicine**

146 Current Perspectives on Less-known Aspects of Headache

number of diseases, chills, and hearing loss.

**Figure 1.** "Creation cycle" and "destruction cycle" (this figure is originally created by authors).

Traditional Oriental medicine is based on "Yin" and "Yang" and the "Five Elements Theory" [4, 5]. "Yin" and "Yang" are mutually opposed, representing related aspects of objects and ideas, such as male and female, right and left, and morning and evening. The Five Elements Theory describes five elements: wood, fire, earth, metal, and water, with everything in the world belonging to one of these five elements. For example, the liver, heart, spleen, lungs, and kidneys fall under the elements of wood, fire, earth, metal, and water, respectively. Of note, the liver and heart in Oriental medicine are not the same as the liver and heart as understood in Western medicine; the liver controls the systemic blood flow and Qi. Qi is a transmutable energy in traditional Chinese medicine that is presumed to flow through 12 meridians in the body [6]. Functional damage to the liver subsequently induces headache and vertigo. The heart controls mental activity, such as memory and intelligence, as well as the tongue; therefore, heart dysfunction can cause taste and language dysfunction. The spleen controls the digestion and absorption of food from the stomach, so spleen dysfunction induces stomachache and diarrhea. The lungs control breathing, and the skin is a barrier against external chemicals and infection. Therefore, lung dysfunction results in catching a cold and respiratory dysfunction. The kidneys control vitality and are related to the ears, so kidney dysfunction can cause a

Acupuncture has been used to treat various diseases, and there are many reports, from various countries around the world, on the use of acupuncture as a therapy for headaches. Acupunc‐ ture has been used to relieve tension‐type headaches and prevent migraine attacks.


**Table 1.** The finger‐cun measurement methods (this table is originally created by authors based on Ref. [7]).

**Figure 2.** F‐cun (this figure is originally created by authors).

Acupoints are determined using one of three typical methods [7]. The first is proportional bone (skeletal) cun (B‐cun); this method divides the height of the human body into 75 equal units. Using joints on the surface of the body as the primary landmarks, the length and width of every body part are measured by such proportions [7]. Specifically, we divide the height of the human body into 75 equal units and then estimate the length and width of certain parts of the body based on such units. One unit is equal to 1 cun. B‐cun is the most accurate method, as it measures each person's physical length, but it is complex. As such, other measurements are often used for convenience [7, 8] (**Table 1**). The second method is finger cun (F‐cun), which uses a person's finger width to determine the acupuncture points (**Figure 2**). One B‐cun and 1 F‐cun are almost the same length. F‐cun is determined using two methods. The first is thumb measurement using the width of the interphalangeal joints. Another is middle‐finger cun (**Figure 3**). Middle‐finger cun is the distance between the ends of the two radial creases of the interphalangeal joints of the middle finger is taken as 1 F‐cun when the thumb and the middle finger are flexed to form a circle [7]. The last method is finger breadth, which uses the width of the distal phalanx of the middle finger to determine the acupuncture points (**Figure 4**). This method should not be confused with the middle finger cun. This method is rarely used. Given that all of these methods result in some degree of variation in acupuncture point determination.

**Figure 3.** Middle‐finger cun (this figure is originally created by authors).

**Figure 4.** Finger breadth (this figure is originally created by authors).

human body into 75 equal units and then estimate the length and width of certain parts of the body based on such units. One unit is equal to 1 cun. B‐cun is the most accurate method, as it measures each person's physical length, but it is complex. As such, other measurements are often used for convenience [7, 8] (**Table 1**). The second method is finger cun (F‐cun), which uses a person's finger width to determine the acupuncture points (**Figure 2**). One B‐cun and 1 F‐cun are almost the same length. F‐cun is determined using two methods. The first is thumb measurement using the width of the interphalangeal joints. Another is middle‐finger cun (**Figure 3**). Middle‐finger cun is the distance between the ends of the two radial creases of the interphalangeal joints of the middle finger is taken as 1 F‐cun when the thumb and the middle finger are flexed to form a circle [7]. The last method is finger breadth, which uses the width of the distal phalanx of the middle finger to determine the acupuncture points (**Figure 4**). This method should not be confused with the middle finger cun. This method is rarely used. Given that all of these methods result in some degree of variation in acupuncture point determination.

148 Current Perspectives on Less-known Aspects of Headache

**Figure 3.** Middle‐finger cun (this figure is originally created by authors).

**Figure 5.** The acupoints used for the treatment of headache (this figure is originally created by authors based on Ref [9, 10]).



**Table 2.** Acupuncture point locations (this table is originally created by authors based on Ref. [7]).

**English name**

*Head region*

*Neck and back regions*

*Upper limbs*

*Lower limbs*

**Chinese name Locations**

150 Current Perspectives on Less-known Aspects of Headache

BL2 Cuanzhu On the head, in the depression at the medial end of the eyebrow

horizontal line of the apex of auricle)

the auricular apices

muscle

GV20 Baihui When the ears are folded, GV20 is located at the midpoint of the connecting line between

GB12 Wangu In the anterior region of the neck, in the depression posteroinferior to the mastoid process

BL10 Tianzhu In the posterior region of the neck, at the same level as the superior border of the spinous

GB20 Fengchi In the anterior region of the neck, inferior to the occipital bone, in the depression between the origins of sternocleidomastoid and the trapezius muscles BL43 Gaohuang In the upper back region, at the same level as the inferior border of the spinous process of the fourth vertebra (T4), 3 B‐cun lateral to the posterior median line

GB21 Jianjing In the posterior region of the neck, at the midpoint of the line connecting the spinous

LI4 Hegu On the dorsum of the hand, radial to the midpoint of the second metacarpal bone PC6 Neiguan On the anterior aspect of the forearm, between the tendons of the Palmaris, longus and the flexor carpi radialis, 2 B‐cun proximal to the wrist crease TE5 Waiguan On the posterior aspect of the forearm, midpoint of the interosseous space between the radius and the ulna, 2 B‐cun proximal to the dorsal wrist crease PC7 Daling On the anterior aspect of the wrist, between the tendons of Palmaris longus and the flexor

LU7 Lieque On the radial aspect of the forearm, between the tendons of the abductor pollicis longus

SP6 Sanyinjiao On the tibial aspect of the leg, posterior to the medial border of the tibia, 3 B‐cun superior

carpi radialis, on the palmar wrist crease

tendon, 1.5 B‐cun superior to the palmar wrist

to the prominence of the medial malleulus

BL12 Fengmen In the upper back region, at the same level as the inferior border of the spinous process of

junction of the vertical line of the posterior border of the temple hairline and the

process of the second cervical vertebra (C2), in the depression lateral to the trapezius

process of the seventh cervical vertebra (C7) with the lateral end of the acromion

the second thoracic vertebra (T2), 1.5 B‐cun lateral to the posterior median line

and the extensor pollicis brevis muscles, in the groove for the abductor pollicis longus

ST8 Touwei On the head, 0.5 B‐cun directly superior to the anterior hairline at the corner of the forehead, 4.5 B‐cun lateral to the anterior median line GB5 Xuanlu On the head, at the midpoint of the curved line from ST8 to GB7 (on the head, at the

> The acupoints used for the treatment of headaches are located on the upper trapezius muscle, the splenius muscle, the semispinal muscle, the levator scapulae muscle, and the rhomboids muscle. These include the bladder meridian, BL10; the gallbladder meridian, GB20, GB12, GB21, and BL43 and acupoints in the trigeminal regions, GB4, GB5, and GB6; the stomach meridian, ST8, ST6, and ST and the peripheral limbs; the large intestine meridian, LI4; the liver meridian, LR3; and the triple energizer meridian, TE5, GB34, and others (**Figure 5**, **Table 2**) [7, 9, 10]. The acupoints in the neck and back regions are suitable for electro‐acupuncture (EA).
