Self massage and trigger point therapy for headaches and migraines

Is your headache suitable for massage or trigger point therapy?

The techniques we will show you are very safe, but we don’t want you doing self massage if you have something serious. It is important that this be determined by a professional familiar with your specific needs, but for general information we will run over the various types of headaches and which might benefit. For this we divide headaches into two main types: primary and secondary,

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. About 95% are simple pain from the muscles and joints, and are called tension or cervicogenic (meaning from the neck), while about 5% are headaches such as migraines (1)⁠.

Tension or cervicogenic headaches

Just as muscles and joints from your back can cause back pain, the muscles and joints of your head, jaw and neck can cause headaches.

The muscles

Muscles can cause pain if they are placed under tension or contain lumps known as (myofascial) trigger Points . In the section below we show you the muscles that cause headaches, and the simple treatments you can do yourself.

The joints

Problems with the joints of the neck are also a major cause of headaches (2–5)⁠. For further information about these and how they are treated please see our   article on spinal joint problems. Joint problems require assistance from a properly qualified professional such as a Chiropractor, Osteopath, or a Physiotherapist with appropriate post graduate qualifications

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)⁠. In plain English this means that the muscle and joint problems described above often indirectly cause migraines, so the treatment we discuss may help.

Secondary headaches

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

Scientists have identifies the following muscles as causes of headaches. (1,3,9–15)⁠. In this guide we will show you the basic techniques, then 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
• Temporalis
• Occipitalis
• Masseter
• Frontalis

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.

1. Basic self massage
2. “Thai” home massage
3. 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)⁠.

Pressure technique

These are most suited for the thin muscles that overly the skull or the jaw. The basic technique is as follows.

1. 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.
2. 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.
3. Finish with about 5-10 seconds of gentle rubbing using a circular motion about 1 cm in
   diameter.

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

MUSCLES

Upper trapezius
SCM (Sterncleidomastoid)
Sub occipital
Splenius capitus
Temporalis
Occipitalis
Masseter
Frontalis

SCM (Sterncleidomastoid)

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.

Massage considerations

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.

Suboccipital muscles

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.

Massage considerations

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.

Massage considerations

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.

Massage considerations

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

References

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3. Jaeger B. Are “cervicogenic” headaches due to myofascial pain and cervical spine dysfunction? Cephalalgia. 1989;9(3):157–64.
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