Massage therapy has a multitude of benefits that include increasing range of motion; accelerating recovery time from an injury; enhancing athletic performance; helping to reduce swelling and inflammation; improve circulation and enhance sleep. Today we will discuss another benefit, the ability to help provide significant relief from a variety of headaches.
There are multiple underlying causes for headaches – muscular, vascular, neurologic, fascial, postural; and can often be a secondary symptom of an existing condition. Massage therapy can offer a multitude of techniques that can help manage, and often eliminate the pain.
According to The International Classification of Headache Disorders, headaches can be placed into three main categories:
Three Main Categories of Headaches
1. Primary Headache:
Headaches that are not the result of another medical condition.
Tension Headache: a headache that involves mild to moderate discomfort, and involves a feeling of pressure surrounding the head. This is the most common type of headache. Massage therapy techniques that address the muscles and surrounding fascial connections are usually beneficial.
Migraine Headache: A migraine headache is vascular in nature, and results in rapid constriction (narrowing) of the arteries. The most common type of vascular headache involving abnormal sensitivity of arteries in the brain to various triggers resulting in rapid changes in the artery size due to narrowing (constriction). Other arteries in the brain and scalp then open (dilate), and throbbing pain is perceived in the head. Aura, a sensation of flashing lights due to the nerve impulses, can occur in some cases.
Cluster Headache: The cluster is the big kahuna of headaches and takes no prisoners. This headache is often referred to as the “suicide headache.” Fortunately, this is the least common of all headaches. A “cluster period” can last anywhere from two weeks, three months, or sometimes even longer.
During this cluster period, short intense headaches occur up to eight times a day. It is also characteristic of an episode to hit within hours of falling asleep.
Massage therapy can often help relieve the symptoms, and help provide temporary relief from the symptoms. Deep tissue massage, trigger point therapy, and Active Release Techniques® are recommended alternative therapies for cluster headaches.
2. Secondary headache:
A headache that is the symptom of another condition.
Secondary headaches can be the result of drinking too much alcohol or the result of a concussion.
Massage for secondary headaches is condition-specific, and the primary concern is to seek treatment for the underlying condition causing the headache.
3. Oranial neuralgia:
Occipital neuralgia is a condition involving inflammation or injury to the occipital nerves that run from the top of the spinal cord and through the scalp. The occipital nerves need to pass through various muscles like the sternocleidomastoid (SCM), trapezius and suboccipital muscles. When the muscles are tight, the nerves get pinched between the structures.
A massage therapist trained in advanced medical massage skills like Active Release Techniques® can utilize techniques to help free up space for the nerves to move more freely.
According to statistics from government health surveillance studies published in 2015 by PubMed, the following statistics regarding headaches are as follows:
- 14.2% of US adults 18 or older reported having migraine or severe headaches in the previous 3 months – 2012 NHIS.
- The overall age-adjusted 3-month prevalence of migraine in females was 19.1% and in males 9.0%, but varied substantially depending on age.
- The prevalence of migraine was highest in females 18-44, where the 3-month prevalence of migraine or severe headache was 23.5%.
- The 3-month prevalence of migraine or severe headache has remained relatively stable throughout 2005-2012, with an average prevalence of 20.2% in females, 9.4% in males, and 14.9% overall [corrected]. During this time, the average female to male sex ratio for migraine or severe headache was 2.17.
- The unadjusted 1-year prevalence of migraine in active duty US military service members varied from 1% to 1.9% between 1998 and 2010, ranging from 0.7% to 1.2% in males and 3.5% to 6% in females.
- The 1-year prevalence of “other headache” in this military population ranged from a low of 1.9% in 2003 to a high of 3% in 2010.
- Headache or pain in the head was the fourth leading cause of visits to the emergency department (ED) in 2009-2010, accounting for 3.1% of all ED visits.
- Across all ambulatory care settings, migraine accounted for 0.5% of all visits and other headache presentations for 0.4% of all ambulatory care visits. 52.8% of all visits for migraine occurred in primary care settings, 23.2% in specialty outpatient settings, and 16.7% in EDs.
- In 2010, opioids were administered at 35% of ED visits for headache, while triptans were administered in only 1.5% of visits.
Posture and Tension Headaches
As society becomes more and more tethered to technology, the human body continues to try to adapt. Modern advances in communication are making it more and more important to be available 2-4-7. Our boss reminds us of a change in the meeting; the significant other wants to know when we will be home; you are dying to see how many “likes” you received on that last social media post. This excessive neurological stimulus is a real pain in the neck, literally – and can lead to headaches.
The digital analytics firm Flurry found that the average U.S. consumer spends 5 hours a day on their cell phone! The average person will drop their head forward and down when reading or texting on their phone. This prolonged position is creating an unhealthy postural adaptation that medical professionals have now named “Text Neck.”
Take a look at the image above. The human head weighs between 10 and 12 pounds. An additional 10 pounds of stress is placed on the vertebral column for every inch that the head projects forward. The head in its neutral position places 10-12 pounds of weight on the cervical spine.
For each additional 15-degree angle of the head up to 60 degrees, an additional 27, 40, 49 and 60 pounds are placed on the cervical spine, respectively. This excessive stress on the joints, muscles, and nerves can lead to headaches, a reduction of lung capacity, cardiac issues and significant neck pain.
Kids are spending over 30 hours a week on their phones. Multiply this by 52 weeks and you get a grand total of 1,560 hours a year spent in these compromised postural positions. WOW!
Terminology Made Easy-Peasy
Latin-smachtin! Let’s make this easy.
Many anatomical terms, like muscles, are rooted in Latin, and are often named to illustrate orientation. They are really easy to understand once you get the gist of it.
Capitis = Head – muscles that attach to the head.
Cervicis = Neck – muscles that attach somewhere along the neck.
Thoracis = Mid-back – muscles that attach somewhere along the mid-back.
Spinalis = Next to the spine – muscles that attach closest to the spine.
Semispinalis = Near the spine – muscles that attach near the spine.
Splenius = Muscles that travel in an oblique, rather than anatomically linear direction.
Headaches – Meet The Muscles
Understanding the Muscle Layers
These photos are not provided to overwhelm, there will not be a test! 🙂 I wanted to provide these photos to demonstrate the layers of muscles throughout the body, and how they relate to the occurrence of headaches. As well as provide a deeper understanding of how the implementation of massage therapy can help.
When treating most any soft tissue condition involving muscles, nerves, and fascia, it is necessary to have an understanding of the layers. When treating a deeper layer muscle, it is important to first address the muscles lying on top to loosen up and prepare the more superficial tissues for deeper work. Otherwise, the superficial muscle will guard and prevent effective deeper work.
The most superficial muscle commonly involved with headaches is the trapezius.
Since this muscle lives so close to the surface, it is necessary to address this muscle before attempting to treat the deeper musculature.
The trapezius is a large triangular-shaped muscle that plays an important role in moving, rotating, and stabilizing the shoulder blade (scapula) and extending the head at the neck. While addressing fascial adhesions and trigger points throughout the entirety of the muscle is important, a focus on the upper trapezius at the neck and base of the skull (occiput) is essential.
The upper portion of the trapezius at the occiput is responsible for extending the neck backward (bilaterally), as well as bringing the head to the same side (lateral flexion) and rotating the head to the same side. To best treat this muscle, myofascial techniques should be implemented throughout the entirety of the muscle all the way to the nuchal line (base of the skull).
A massage therapist certified in advanced medical massage, myofascial release, or Active Release Techniques® can yield tremendous results.
Active Release Techniques® is a soft-tissue management system designed to treat muscles, fascia, ligaments, and nerves. Your therapist will use specific techniques to help realign the head muscles, break up any fascial adhesions and help facilitate the healthy movement of the nerves throughout the area. Active Release Techniques® can help reduce the intensity, and often the frequency of headaches and migraines.
Spinalis and Simispinalis Capitis
The spinalis muscle gets its name because of the location, it attaches nearest to the spine. This muscle travels from the uppermost part of the lower back up to the neck, and most of the territory covered is the mid-back (thorax) to the neck (cervix). The semispinalis capitis starts at the mid-back and attaches at the base of the head (occiput).
These muscles are usually involved with headaches that can be described as a feeling “behind the eyes.”
Since these muscles are located so close to the spine, their main action is to extend the head backward.
Massage therapy techniques like the ones mentioned above can effectively address these muscles. Encouraging range of motion at the neck and head while palpating the muscles during treatment can be quite effective.
The splenius capitis muscle is located just deep to the trapezius and superficial to the deeper suboccipital muscles. After a thorough treatment of the trapezius, this muscle should be addressed next when treating tension headaches.
Much like the upper trapezius, this muscle is responsible for extending the head backward (bilaterally), as well as bringing the head to the same side (lateral flexion) and rotating the head to the same side. The treatment protocol is very similar to the spinalis capitis as well. However, this muscle travels more lateral as it approaches the occiput, so hand placement when treating this muscle will be a little more lateral when approaching the base of the skull.
The Deep Suboccipital Muscles Involved In Headaches
You may have experienced a massage therapy session where you were lying on your back and the massage therapist held your head for several minutes, with their fingers pressing at the base of the head/neck. You had no idea what they were doing, but it had that “hurt so good” sensation.
Several muscles that can contribute to headaches insert at this very area, and when your therapist is specific to these muscles . . . you will definitely experience an ahhhh, that’s the spot moment!
Rectus Capitis Posterior Major and Minor
The rectus capitis posterior major and minor are the deepest of the head/neck muscles. These two very small muscles take on a big responsibility. While recent studies have shown the rectus capitis superior minor takes on a host of responsibilities, together they share in the actions of head extension and rotation to the same side.
These two muscles are often involved with headaches that begin at the back of the head and move to the area behind the eyes.
Massage therapy techniques aimed at reducing the tension in these muscles can have a profound effect on the reduction of symptoms associated with tension headaches.
Obliquus Capitis Superior
This another muscle that extends the head and lateral flexes it to the same side. This muscle, in addition to the trapezius, semispinalis capitis, splenius capitis, and rectus capitis major/minor should be assessed when treating symptoms involved with the tension headache.
The temporalis muscle attaches to the temporal fascia and the ramus of the mandible. Due to this connection, it can cause tension throughout the temple, behind the eye, along the eyebrow and even in the area around the upper teeth.
Myofascial adhesions and trigger points are common in this area. Massage therapy involving gentle Swedish circular techniques, trigger point therapy, and Active Release Techniques® can help relieve these symptoms.
The masseter muscle is most often associated with TMJ (Temporal Mandibular Joint Disorder). However, one of the most common headaches, the tension headache, can be caused by the subconscious clenching of the teeth due to stress. The masseter muscle is the muscle that attaches the jaw bone to the cheekbone, its main job is to close the jaw (elevates the mandible). When we clench our teeth due to stress, this creates a chain reaction and other muscles of the neck react. This chain of events can lead to a headache.
Circular friction, trigger point therapy, and pin-and-stretch massage techniques can be helpful when addressing this area.
The occipitalis can often become fibrotic, especially due to overuse during stressful situations. This set of muscles on the back of the head moves the scalp backward and is active when you raise your eyebrows.
There are fascial attachments between the occipitalis, splenius capitis and the semispinalis capitis, so a treatment strategy that involves all three of these muscles may be considered. There are often trigger points that can be addressed to help reduce the severity of a headache.
Tips to Help Avoid Headaches
Stress is one of the leading triggers to cause headaches. Serotonin is a mood-regulating hormone and is beneficial to the body in normal quantities. However, during periods of stress this hormone can be abundantly produced, causing blood vessel constriction and reduced blood flow. This rapid increase in serotonin can trigger migraines.
Tips to reduce stress include practicing focused breathing exercises like the 4-7-8 breathing technique,
Foods Can Trigger Headaches
The food we eat, when combined with other migraine triggers, can increase the likelihood of the onset of a migraine. Try to reduce the consumption of foods that can trigger migraines, such as chocolate, caffeine, alcohol and salty foods.
According to the American Migraine Foundation, a well-balanced exercise program can help to reduce the frequency and intensity of headaches and migraines. During exercise the body releases endorphins. Endorphin, broken down means endogenous (from within the body) morphine (opiate pain reliever). So, endorphins are natural pain relievers produced by the body and can help reduce the onset of headaches. Dehydration can lead to migraine headaches, so make sure you stay well hydrated before, during and following your workout.
- Curb Your Caffeine ConsumptionAs a New Yorker, this one can be a hard pill to swallow, or not. The bad news – caffeine can cause a headache. When a regular drinker of coffee discontinues, the body reacts by expanding the blood vessels, which can lead to a headache. Now, you are probably asking, does this mean drink more coffee . . . I’ll let you be the judge on this one. 🙂 The good news – caffeine can help. According to Harvard Medical School, the polyphenols and other anti-inflammatory compounds found in caffeine can help a headache by reducing inflammation.
Perfect Your Posture
When at work, make sure your computer monitor is 16-29 inches away, and the top of the monitor should be in line with your eyes. When using a computer mouse, make sure to keep your hand, wrist and forearm parallel to the floor, and click your mouse lightly. The curve of your desk chair should match the natural curve of your lower back. Keep your elbows close to your sides and your feet flat on the floor. Take posture breaks 2-3 times per hour by standing and rolling your shoulders.
Make Time for Massage
We already discussed how utilizing massage therapy to target the muscular system can help to reduce the symptoms associated with various types of headaches. Also, massage therapy techniques that target the cardiovascular, nervous, endocrine and respiratory systems have also shown to be beneficial. benefit.
Swedish relaxation massage can help promote relaxation and help to reduce stress by activating the parasympathetic nervous system. Massage can help lower blood pressure, heart rate, and stress hormones.
Massage has been shown to reduce stress and promote relaxation. It can activate the parasympathetic nervous system, which lowers your heart rate, blood pressure, and stress hormones during a massage. Massage.can also have a tremendous help release the hormone serotonin, which when released at optimum levels can help relieve the pain and throbbing ass
Richard A. Lehman, LMT, CSCS
The ProLon Fasting Mimicking Diet Review Dietary crazes and trends come and go, but the science that supports some and not others doesn't fade away. Instead, scientists conduct more research to...
11 Best Types of Massage for Tennis Elbow A great game of tennis can leave you feeling on top of the world. However, it may also leave your outer elbow feeling sore, tight, and painful....