Movement of the arms and legs keeps declining while the volume of information we are exposed to keeps rising, so mental and emotional labour increase. The head therefore carries a heavier load than it once did, and headaches inevitably multiply. It is a companionable sort of ailment for me personally, and a great many people live with it.
In Summary
- Around 52% of the world’s population has a headache each year and 14% migraine; 4.6% have headaches on 15 or more days a month.
- Headache is more common in women than men — migraine prevalence 17% versus 8.6%.
- Korean Traditional Medicine (KTM) treats one question as decisive when choosing treatment: is this from a deficiency of qi (heo, 虚) or from qi in excess and therefore stagnant (sil, 實)?
- For headache, both exist. When the energy sent to the head falls short of what the head is spending, that is qi-deficiency headache; when energy floods the head all at once and stagnates in one place, that is qi-excess headache.
- Deficiency headache responds to putting qi in; excess headache responds to moving qi and clearing the blockage.
- Telling them apart is not easy in practice. The same person may have a deficiency headache before a meal and an excess headache after one.
How Common Headache Actually Is
According to one analysis, 52% of the global population experiences headache each year and 14% migraine. Those with headache on 15 or more days a month come to 4.6%. The same work found that 15.8% of the world’s population has a headache on any given day, of whom around 7% have migraine.
Headache is more common in women than in men. Migraine prevalence in women is 17% against 8.6% in men, and the proportion having headaches on 15 or more days a month is 6% of women against 2.9% of men — roughly double.
One limitation: this research draws mostly on high-income countries with good medical systems, so it may not reflect every population. What is clear regardless is that headache is extraordinarily widespread. If roughly 5% of people hurt on 15 or more days a month, then I am not such an unusual case after all.
Deficiency or Excess?
In KTM, the traditional healing system of Korea also known as Hanbang (한방), the action of qi (氣) is taken as the foundation of every living process. So when deciding how to treat, it matters enormously whether a condition arose from a shortage of qi — a deficiency pattern — or from qi in excess that has become stagnant, an excess pattern.
For headache, the honest answer is that both exist.
Sometimes the energy being sent up to the head is less than what the head is using. That is a state of deficiency. Conversely, when a large amount of energy rushes to the head all at once and the qi stalls in one place, a headache arises from that too.
Qi-Deficiency and Qi-Excess Headache
Classified simply, then, there is qi-deficiency headache — the headache of too little energy — and qi-excess headache, the headache of too much. Where it is deficiency, supplying qi resolves it; where it is excess, circulating the qi and drawing off the obstruction treats it well.
In practice, though, distinguishing the two is not straightforward. The same person may develop a deficiency headache before a meal, when energy is short, and an excess headache after one, when energy has become abundant.
In Summary
Headache has an unusually wide range of causes. So this series begins by setting up this frame of deficiency and excess. The next article looks at the pathological feature common to both — heat above and cold below — before moving on to the causes and treatment of headache constitution by constitution.
Related reading: The Brain in Korean Medicine: The Sea of Marrow · Exercise and Digestion in Korean Medicine
This article reflects the teaching and research of Professor Seungho Baek, Professor of Korean Medicine at Dongguk University College of Korean Medicine, specializing in Pathology and Oncology.
