Headache

Medically reviewed by Dr. Tony Willcox, PhD, D.A.O.M., A.P.
Last reviewed: September 2026

Headache covers a range of conditions, but most fall into a few categories. Tension-type headache is by far the most common — a dull, pressing, band-like ache around the head, often tied to stress, muscle tension, posture, and fatigue. Migraine is a distinct and often more severe headache with its own features, covered on its own page. Cluster headaches, sinus headaches, and others each have their own patterns. Most headaches are primary, meaning another underlying disease doesn’t cause them. But because a small number can signal something serious, it is important to know the warning signs — covered below — that call for prompt medical care.

Headaches vary by type, but tension-type headaches — the most common — typically bring:

• A dull, aching pressure, often described as a tight band around the head
• Tenderness in the scalp, neck, and shoulder muscles
• Pain on both sides of the head
• A sense of tightness rather than throbbing
• Headaches triggered or worsened by stress, poor posture, or fatigue

Common triggers and contributors include stress and anxiety, muscle tension in the neck and shoulders, poor posture, eye strain, dehydration, poor sleep, and — importantly — the overuse of pain medication, which can paradoxically cause rebound headaches. Because so many headaches are driven by tension and stress, an approach that addresses both the muscles and the nervous system can be especially helpful.

In Chinese medicine, headaches are understood according to their location, quality, and cause. A tension headache might reflect Liver Qi stagnation from stress, or an obstruction of Qi and Blood in the channels that cross the head and neck, often accompanied by tight, knotted muscles. Other headaches may stem from patterns of heat, dampness, or underlying deficiency. The location offers clues — a headache at the temples is read differently from one at the back of the head or the forehead. Treatment aims to release the obstruction, ease the muscular tension, calm the Liver, and restore smooth flow. Dr. Willcox identifies the specific pattern before treating.

Acupuncture for headaches is thought to work by releasing the muscular tension in the neck, shoulders, and scalp that drives so many headaches, calming the nervous system’s processing of pain, and encouraging the release of the body’s natural pain-relieving compounds. For headaches with a strong muscular component, treatment of the tight bands and trigger points in the neck and shoulders can be especially effective.

This is one of acupuncture’s best-supported uses. A Cochrane review — among the most rigorous forms of medical evidence — found that acupuncture can reduce the frequency of tension-type headaches, concluding it could be a valuable non-drug option for people with frequent or chronic tension headaches. Acupuncture also has strong Cochrane-reviewed evidence for reducing the frequency of migraines, which you can read about on the migraine page. For people looking to reduce their reliance on pain medication — and avoid rebound headaches — this drug-free track record is especially appealing.

At Acupuncture Zen, headaches are often addressed with acupuncture, sometimes with dry needling of the neck and shoulder muscles, electro-acupuncture, or cupping — always as a complement to appropriate medical care.

A first visit begins with a thorough conversation about the headaches — where they occur, how often, what they feel like, what triggers them, and any diagnosis or medications already in place. Dr. Willcox may assess the neck and shoulder muscles for tension. Treatment involves fine needles at points on the head, neck, and body, often with attention to the muscular tension that feeds headaches, followed by a period of rest. Because headache prevention builds over time, treatment is usually a series of sessions aimed at reducing both frequency and intensity. Dr. Willcox coordinates with a patient’s physician.