Massage and Tension Headaches

Headache? Those with tension type headache (TTH) describe them as pressure or tension, tightening pain in the head that is generally on both sides of the head and not aggravated by usual physical activity. Tenderness around the head may also occur.  Did you know that tension type headache is the most common headache disorder in the world? Prevalence estimates range from 22% to 40%.

Tension-type headache affects daily functioning, resulting in limitations in performance and participation. Common treatment for TTH frequently involves recommended medications but these can have significant side effects.  A recent study suggests that trigger point release massage therapy may reduce headache frequency. Myofascial trigger points (MTrPs) as they are commonly called are focal problems in skeletal muscle that can send pain to the head and reproduce the pain patterns of tension-type headache (TTH). In the study,fifty-six subjects with TTH were randomized to receive 12 massage or placebo sessions over six weeks, or to wait-list. Trigger point release (TPR) massage focused on MTrPs in neck muscles. Headache pain (frequency, intensity and duration) was recorded in a daily headache diary. Additional outcome measures included self-report of perceived change in headache pain and pressure-pain threshold (PPT) at MTrPs in the neck muscles.  The results showed that there was a greater reduction in headache pain for massage than placebo or wait-list groups (p=0.002). In addition, PPT improved in all muscles tested for massage only.

Massage therapy should be considered an adjunct treatment for episodic TTH that could be combined with medications for the management of chronic TTH. Because massage therapy has no serious adverse effects it has been suggested that doctors consider massage
therapy for the treatment of tension type headache.


1: Moraska AF, Stenerson L, Butryn N, Krutsch JP, Schmiege SJ, Mann JD. Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial. Clin J Pain. 2015 Feb;31(2):159-68. doi: 10.1097/AJP.0000000000000091. PubMed PMID: 25329141; PubMed Central PMCID: PMC4286457.

2: Gerber LN, Kumbhare D. Physiatry Reviews for Evidence in Practice Second-Order Peer Review: Does Massage Therapy Have Value in the Treatment for Tension Type Headache? Am J Phys Med Rehabil. 2018 Feb;97(2):141-142. doi: 10.1097/PHM.0000000000000833. PubMed PMID: 29342023.


About the Author:

Dean Smith, DC, PhD, husband, and father of two children, is a highly respected health and wellness authority. He is a chiropractor at Essence of Wellness Chiropractic Center and a researcher and clinical professor at Miami University. Dr. Smith incorporates lifestyle intervention (exercise, nutrition, other non-drug methods) with chiropractic adjustments and other manual methods to encourage optimal wellness. He has helped countless adults and children lead a life of wellness. His research interests lie broadly in the area of human movement and coordination. He is most interested in how chiropractic, exercise and rehabilitation affect human performance. His scientific articles have been published in such journals as Human Movement Science, Journal of Manipulative and Physiological Therapeutics, Journal of Strength and Conditioning Research, Chiropractic Research Journal, Chiropractic and Osteopathy and The Open Neurology Journal. His training includes a Master’s degree in exercise science, a Doctor of Chiropractic degree and a PhD in brain and cognitive science with a focus on motor control and coordination. The International Federation of Sports Chiropractic has awarded him with the International Chiropractic Sport Science Diploma (ICSSD).

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