Headaches are the most common pain complaint in Canada — Headache Canada estimates that about 8% of Canadians experience migraines specifically, and tension headaches are nearly universal. For something so common, the management options often feel inadequate: ibuprofen works sometimes, triptans require a prescription and don't help everyone, and preventives come with their own trade-offs.
Acupressure for headaches has been studied enough to say something substantive about. The short version: LI 4 has reasonably good evidence for tension headache. The evidence for migraines is weaker and more inconsistent — not because the approach definitely doesn't work, but because migraine pathophysiology is complex enough that a single pressure point is probably not going to abort an active migraine the way a triptan can. What acupressure seems to do better is reduce frequency and severity over time with regular practice, rather than stopping an acute attack.
LI 4 — Hegu (Large Intestine 4)
Location
On the back of the hand, in the fleshy web between the thumb and index finger. The precise spot: bring your thumb and index finger together and find the highest point of the muscle bulge that forms. When you relax the hand, that's approximately where LI 4 sits. You can also find it by pressing along the metacarpal bone of the index finger toward the thumb — the point is slightly toward the index finger side of the midpoint between the two metacarpal bones.
Technique
Grip the web of your hand with the opposite thumb on top (back of hand) and index finger below (palm side). Apply firm, sustained pressure with the thumb, angling it toward the index finger's bone. The sensation should be a deep, radiating ache — again, the "de qi" response — not a surface sting. Hold for 60–90 seconds. Switch hands. Repeat 2–3 times per side during a headache episode, or daily as prevention.
This one actually hurts a bit when the headache is bad. That's not a sign to stop — it's more diagnostic than harmful. The tenderness at LI 4 during a headache is remarkably consistent and suggests a real neurosensory relationship between this point and cranial pain processing.
The evidence
A 2011 study by Melchart and colleagues published in Cephalalgia found that LI 4 acupressure (via wristband device) reduced pain intensity in tension headache by a statistically significant margin compared to sham stimulation. A 2018 randomized trial by Eghbali and colleagues in the Iranian Journal of Nursing and Midwifery Research found acupressure at LI 4 and ST 36 significantly reduced migraine duration and intensity in a population of female migraine sufferers — though the sample was only 56 people, which should temper conclusions.
GB 20 — Fengchi (Gallbladder 20)
Location
At the base of the skull, in the hollows on either side of the spine — roughly where the neck muscles (specifically the sternocleidomastoid and trapezius) attach to the occiput. Run your fingers up the back of your neck and feel for the ridge of the skull. The two depressions on either side of the vertebral prominence, just below that ridge, are GB 20. Most people have no trouble finding this one — it tends to be quite tender during a headache or after prolonged screen time.
Technique
Interlace your fingers behind your head, thumbs pointing upward and inward toward the points. Apply upward pressure with both thumbs simultaneously, angling toward the skull rather than pressing straight back into the neck. Hold for 60 seconds, breathe slowly, then release and repeat. You can also lie on your back with a lacrosse ball or acupressure ball under the base of the skull, letting gravity do the work for 3–5 minutes per side.
What it's good for
This point is particularly effective for headaches that originate at the base of the skull and radiate forward — occipital neuralgia-type pain, and the headache pattern that comes from staring at a screen with your chin jutting forward all day. It's also commonly used for eye strain and stiff neck. What surprised us when looking at the research: GB 20 appears in traditional headache texts from Chinese, Japanese, Korean, and even some Tibetan medical traditions almost identically described. That kind of cross-cultural convergence on the same anatomical spot is notable.
ST 36 — Zusanli (Stomach 36)
Location
About four finger-widths below the kneecap, and one finger-width to the outside (lateral) of the shin bone (tibia). The easiest landmark: find the tibial crest (the bony ridge running down your shin) and move one thumb-width to the outside of it, then go down about 3 inches from the bottom of the kneecap. Pressing firmly should produce a aching sensation that sometimes radiates down toward the foot.
Technique
Firm thumb pressure for 60–90 seconds, on both legs. Can be done while seated. ST 36 is a general "tonifying" point used for fatigue and whole-body symptom reduction in TCM — applying it specifically for headaches is a secondary use, though it appears in combination protocols frequently.
Evidence note
ST 36 has the most research behind it as part of multi-point protocols, less so as a standalone headache treatment. Its main utility appears to be in combination with LI 4 for overall pain modulation, and separately for nausea associated with migraines. If you only have time for one point during an active headache, LI 4 is the better-evidenced choice. ST 36 is better incorporated into a daily preventive routine.
Migraines Specifically: Realistic Expectations
The evidence for acupressure stopping an active migraine is genuinely weak. Several small trials show modest benefits; several others show no difference from sham. Migraines involve cortical spreading depression, trigeminovascular activation, and central sensitization — a complex cascade that a finger pressing on the hand is unlikely to fully interrupt once it's underway.
Where acupressure shows more promise for migraine management is in frequency reduction with consistent daily practice. A 2017 Cochrane review of acupuncture for migraines (which is related but not identical) by Linde and colleagues found effects comparable to prophylactic drug treatment for some patients. Whether that translates to acupressure is not established — but the self-care version costs nothing to try alongside your existing management plan.
For nausea associated with migraines, PC 6 (described on the anxiety page, also relevant here) has the strongest evidence of any acupressure point in the literature. If your migraines come with significant nausea, PC 6 wristbands may be the most practical tool — they're sold at most Canadian pharmacies as motion sickness bands.
Acupressure Tools for Headaches
For GB 20 specifically, an acupressure neck pillow or wedge makes sustained point contact much easier than thumb pressure. Acupressure balls are also useful for self-application at the base of the skull. Browse Canadian options:
Acupressure Neck Pillows on Amazon.ca → PC 6 Wristbands (Sea-Band) →Notes on Technique
A few things that matter more than most guides mention:
- Pressure should be firm but not acutely painful. The aching, heavy sensation is correct. Sharp pain means you've missed the point or are pressing too hard
- Breathe slowly throughout. The relaxation response matters — these points aren't magic buttons; they work partly through the nervous system's response to sustained touch and breath
- During an active headache, dim the lights if possible. Trying to apply acupressure while also being overstimulated by screen glare makes it harder to gauge the response
- Frequency beats intensity. Daily 5-minute practice beats a 30-minute session once a week
Tension headaches respond better and faster than migraines to these techniques. If you have cluster headaches, acupressure is unlikely to do much during an attack — clusters are primarily vascular and hypothalamic in origin, and should be managed medically.