Is your headache suitable for massage or trigger point therapy?
Whether massage or trigger point therapy will be useful will depend upon the cause of your headaches. These causes are grouped as either primary or secondary. We will look at each. Of course diagnosing the cause is the job of a professional, so we ask that you always seek advice from a professional familiar with your own needs to ultimately work out the cause and whether any therapy is appropriate or not.
Primary headaches (the main type)
Primary headaches are those not caused by another disorder. They are typically caused by pain from pain sensitive structures around the head and neck. Of these about 95% are typical tension or cervicogenic headaches while about 5% are headaches such as migraines (1).
Tension or cervicogenic headaches
These involve pain from muscles and joints, just like other musculoskeletal conditions such as back, neck and shoulder pain.
While there are a lot of muscles in your neck, there are also muscles associated with your jaw movement and thin layers of muscle covering some of your skull. Any of these muscles can cause pain due to tension and due to the development of (myofascial) triggerpoints. For more information on trigger points see our Complete guide to (myofascial) trigger points. Later in this article we will go over the individual muscles involved.
Problems with the joints of the neck are also a major cause of headaches (2–5). For further information about what these problems are and how they are treated please see our article Do vertebrae get misaligned or go out of place. It describes the joint problems that cause back pain, but exactly the same principles apply for joints in your neck. They are just a bit smaller.
The self massage and trigger point therapy we will show you should definitely be very helpful relieving pain from muscle tension and trigger points. Joint problems require assistance from a properly qualified professional such as a Chiropractor, Osteopath, or a Physiotherapist with appropriate post graduate qualifications. Most likely, to get great lasting results you will need a combination of both professional help for the joints and home massage or trigger point therapy for the muscles.
Migraine type headaches
Migraines are a lot more complex. However, scientists have found a strong association between migraines and issues such as trigger points and abnormal neck function (2,4–8). This appears to be caused by a similar mechanism to the way that trigger points cause fibromyalgia. That is, the prolonged pain from issues such as trigger points cause the nervous system to become sensitised. If this is the case, the treatments discussed for tension and cervicogenic headaches will be very helpful.
Secondary headaches result from other conditions such as diseases or tumours. These are far less common, but need to be identified when they exist so the proper care is received.
Self massage and trigger point therapy
In this section we will look at:
- an overview of the muscles involved,
- basic self trigger point therapies and massage techniques,
- special techniques for muscles of the head area,
- acupressure and other therapies,
- advice for each individual muscle, and
- APPENDIX: a summary of clinical trials
Overview of the muscles involved
According to several studies the muscles involved in headaches are as follows (1,3,9–15). Later we will go over each muscle individually, showing where the common problems are and recommending the best treatment for each.
Most important muscles for headaches
- Upper trapezius
- SCM (Sterncleidomastoid)
- Sub occipital
Other important muscles
- Splenius capitus
The basic self massage and trigger point therapy techniques
We recommend the following easy to apply home massage and trigger point therapies. We discuss how to examine your muscles and do these therapies our article How to treat trigger points at home.
- Basic self massage
- “Thai” home massage
- Vibration massage (the best)
Special techniques for the muscles of head, neck and jaw
Many of the muscles of the head, neck and jaw are very thin or overly sensitive structures so the basic massage and trigger point therapies techniques above are sometimes not appropriate. Because of this we will give you some modified techniques. These are an amalgamation of the techniques used and found to be very effective in several clinical trials (1,9,13,14,16).
These are most suited for the thin muscles that overly the skull or the jaw. The basic technique is as follows.
- Using the tip of your finger(s) examine the muscle for tightness and tender lumps (trigger point). Because some of the muscles are thin these lumps may only be felt as localised areas of tightness.
- Once found, using the same finger tip(s) apply pressure to your tolerance. You may feel the pain fade and/or the muscle relax. Maintain this pressure until this relaxation is felt, or for a maximum of two minutes.
- Finish with about 5-10 seconds of gentle rubbing using a circular motion about 1 cm in
Acupressure and other techniques
There are many systems of points that are said to benefit headaches and other conditions. Examples are acupuncture/acupressure and shiatsu. There is a very large overlap between these points and trigger points (17). The easiest way to think of these is that over time different people or cultures have found basically the same points but made up their own story around them. The description of trigger points is based upon science. The take home message is that you just look for the changes in the muscles and treat them irrespective of the label they have been given. In separate articles on sleep, high blood pressure and anxiety we discuss that scientists have successfully used massage and trigger point therapy to help these conditions without considering any special system of points.
specialised techniques for muscles of the head area
The diagram below shows the SCM muscle with "x" marking the the site of common trigger points and the red being where those trigger points commonly refer pain to.
The SCM overlies several sensitive structures therefore we only recommend you use pinching techniques. To help find the correct muscles and use the correct technique the second picture below shows the SCM bulging at the front.
The diagram below shows the suboccipital muscles with "x" marking the the site of common trigger points and the red being where those trigger points commonly refer pain to.
These muscles are deeper and at the base of your skull. I'd personally use a vibration massager for the quickest and best results, but for a non-professional a pressure technique using your thumb is probably easiest and best. The picture below shows someone else applying the pressure, but it is easy to use your own thumb. These muscles are often tight secondary to a joint problem so if the issues are difficult to clear or keep coming back please consult a professional such as a Chiropractor, Osteoptah or a Physiotherapist with special post graduate qualifications.
Splenius capitus muscles
The picture below shows this muscle with the common trigger points and their pain referral pattern.
These are quite substantial muscles not overlying anu highly sensitive structures, therefore vibration massage, self massage and pressure techniques all work well. If you use pressure limit it to light to moderate, and if you use vibration avoide vibrating your skull.
Temporalis, Occipitalis, Masseter and Frontalis muscles
As shown below these four muscles sit over your skull and your jaw and commonly refer headache pain.
Because all these muscles are relatively thin and overly either your skull or your jaw we only recommend pressure techniques using the pads of your fingers. However, the muscles are all easy to reach and very easy to massage. There are some example pictures below.
Other self massage and trigger point therapy articles
If you found this useful please check out our other self massage and trigger point therapy articles.
- Massage And Trigger Point Therapy For Low Back Pain, With Self Help Options
- Massage And Trigger Point Therapy For Calf Pain, With Self Help Options
- Massage And Trigger Point Therapy For Shoulder Pain, With Self Help Options
- Self Massage And Trigger Point Therapy For Tennis Elbow
- Trigger Point Therapy For Fibromyalgia: Inc. Self Help Advice
- Self Massage For High Blood Pressure
- Self Massage For Anxiety
Appendix: summary of clinical clinical trials of massage and trigger point therapy for headaches and migraines
NOTE: You may need to scroll the table below left/right for more information
What they did
One session of trigger point therapy using simple pressure techniques
Relief for about 52% of sufferers. Researches said that these simple techniques can be self applied
Eight 30 minute sessions of massage and trigger point therapy over four weeks Eight sessions of acupressure over one month.
Excellent reduction in frequency of headaches (see chart below)
Eight sessions of acupressure over one month.
Significant reduction in headaches, including at six moth follow up. The acupuncture points identified by their meridian and number. These largely coincided with the sites of common trigger points.
Trigger point therapy twice a week for an average of 6.5 sessions
Headache frequency reduced 67.7%, intensity by 74.3%, and duration by 77.3%. No side effects were noted.
Self trigger point therapy three times a day for four weeks.
Intensity, frequency and duration of headaches and use of medications all reduced