A headache is pain in the head and neck region that can be classified as muscular (tension), vascular (congestion), or traction-inflammatory (pathological). Headaches can have a sudden or gradual onset. The pain can be on one or both sides of the head and neck. It is not within the massage therapy scope of practice to diagnose or prescribe. All treatments mentioned, other than massage, are typically self-administered or prescribed by a healthcare professional. Who can prescribe treatments within their scope of practice. These treatments are mentioned because clients may already be using them when they come for a massage. I always ask if the client has any health issues or is using treatments that may be affected by massage.
Tension headaches are the most common type of headache, caused by muscular tension or hypertonic muscles. Some of the muscles often involved with tension headaches include the sternocleidomastoid, suboccipitals, masseter (jaw muscle), and neck extensors (splenius cervicis and splenius capitis). Tension and trigger points in these muscles refer pain into the head and contribute to tension headaches. The pain typically occurs bilaterally (both sides) in the head and neck region. Massage is indicated for tension headaches at all stages. There are numerous self-treatments for tension headaches, but doctors may prescribe ice to reduce pain and muscular spasm. Also pain and/ or anti-imflammatory medication, muscle relaxants, or nutritional supplements such as magnesium and feverfew.
Vascular headaches, also known as congestion headaches, are related to increased blood flow within the vessels in the cranium. Vasodilation can put pressure on the nerves, and pressure on nerves causes pain and discomfort. They are often associated with unilateral (one-sided) throbbing or stabbing pain, but the symptoms can also occur bilaterally. Massage is indicated for tension headaches at all stages. This type of headache may require diagnostic testing such as magnetic resonance imagery (MRI) or computed tomography (CT) scan to rule out underlying pathology. Once pathology has been ruled out, professionally prescribed drug treatments may include. Pain medication, anti-inflammatory medication, muscle relaxants, serotonin reuptake inhibitors, or tricyclic antidepressants. Other than drug therapy, doctors sometimes identify the client’s nutritional sensitivities and use stress management techniques such as acupuncture, biofeedback, exercise, and massage.