Tension Headache - Liver-Qi Stagnation Pattern

TCM differentiation and treatment for tension headache

Tension Headache · Liver-Qi Stagnation Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

Pattern Overview

Liver-Qi Stagnation is the most common pattern in tension headache,

characterized by **sustained pericranial muscle contraction, central

sensitization, headache worsened by stress, chest tightness, and

frequent sighing. The core pathogenesis is emotional stress causing

Liver-Qi stagnation**, leading to muscle tension, central sensitization,

and headache.

Key Symptoms and Differentiation Points

Differentiation Dimension Manifestations
Primary Symptoms

tight quality), worsened by stress |

Associated Symptoms

irritability, depression |

Tongue and Pulse

pulse |

Pathogenesis

central sensitization |

Etiology

sedentary lifestyle |

Acupuncture Point Prescription

Point Location Function
Fengchi (GB20)

sternocleidomastoid and trapezius | Relaxes neck tension and clears the

head |

Taiyang (EX-HN5) In the depression at the temple

headache and calms the spirit |

Taichong (LR3)

metatarsals | Source point of Liver meridian; soothes Liver-Qi |

Hegu (LI4)

metacarpals | Regulates Qi and relieves pain |

Waiguan (TE5) 2 cun above the wrist crease, dorsal side

Unblocks the Triple Energizer meridian; treats headache |

Clinical Recommendation: Filament needle, reducing method; combine

with deep breathing and stress reduction techniques.

Herbal Formula

Base Formula: Chai Hu Shu Gan San (柴胡疏肝散)

Composition:

Bupleurum (Chai Hu), White Peony (Bai Shao), Immature Bitter Orange (Zhi

Ke), Cyperus (Xiang Fu), Chuanxiong (Chuan Xiong), Tangerine Peel (Chen

Pi), Licorice (Gan Cao)

Action: Soothes Liver-Qi, regulates Qi flow, and relieves headache.

Modifications

Associated Symptoms Additions/Subtractions
Pronounced depression Add Yu Jin, He Huan Pi to relieve depression
Chest tightness

distension |

Insomnia Add Suan Zao Ren, Yuan Zhi to calm the spirit
Prolonged headache

and stop pain |

Western Mechanism Reference

Sustained pericranial muscle contraction with central sensitization,

elevated EMG activity, and decreased pain threshold. Liver-Qi Stagnation

corresponds to tension headache associated with stress, where

sympathetic overactivity and sustained muscle contraction contribute to

central sensitization and headache.

References

1. Internal Medicine of TCM - Headache with Liver Depression.

2. Xiong Jibai: Liver Depression uses Chai Hu Shu Gan San.

3. WHO. (2023). Headache disorders. World Health Organization.

Explore More

Personalized herbal protocols and acupressure tools for headache relief.

research papers and clinical case studies on TCM headache management.

Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM | Content updated: Monthly

Disclaimer: This guide is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any treatment.