It’s three in the afternoon and your head feels like it’s in a vise. The pressure sits across your forehead and wraps around to the back of your skull. Your shoulders are somewhere up near your ears, and you can’t remember when they came down.
That’s the classic tension headache, and it’s the most common kind of headache there is.
People ask us all the time whether a massage will help. For a lot of them, it does. It helps most when you know what’s going on and you ask for the right kind of work.
Why does a tight neck give you a headache?
A tension-type headache usually feels like a dull, steady pressure on both sides of the head. It doesn’t throb the way a migraine tends to, and most people don’t feel sick to their stomach or need a dark room. You can usually keep working through one. You just don’t enjoy it.
The muscles at the top of your shoulders and the small ones at the base of your skull have a habit of referring pain. A tight knot in the upper trapezius, the muscle that runs from your neck out toward your shoulder, can send an ache up the side of your head and into your temple. The little muscles where your skull meets your neck can do the same thing behind your eyes.
So the headache you feel in your forehead may have started a few inches lower.
Long stretches at a laptop, a phone tucked between ear and shoulder, a bad pillow, clenching your jaw while you concentrate: all of these keep those muscles working when they should be resting. Stress tightens them further. By late afternoon, they’ve had enough.
What should you ask for at your massage?
Tell your therapist where the headache usually sits and where it seems to start. “It begins at the base of my skull and ends up over my right eye” is far more useful than “I get headaches.”
For this kind of problem, a deep tissue massage aimed at the neck, shoulders and upper back is often a better fit than an all-over relaxation session, though plenty of people do well with Swedish if firm pressure makes them tense up. We offer both in 60 or 90 minutes. If headaches are the main reason you’re coming in, the 90 gives the therapist time for your neck and shoulders without rushing the rest of you.
Two of our add-ons were made for this. The scalp massage works the head, neck and the top of the spine. Trigger point therapy is a focused 30 minutes on specific knots, the ones that reproduce your headache when pressed. That last part sounds unpleasant, and for a few seconds it can be. Say so if it’s too much. Good pressure should feel like it’s working on something, never like you need to hold your breath.
A few practical things we’d suggest:
- Book between headaches if you can. Firm work on a neck that is already in the middle of a bad one can feel like too much, and you’ll get more out of the session on a decent day.
- Drink some water afterward and go easy on your neck that evening. A little soreness the next day is normal after deeper work.
- Pay attention to your next two weeks. If the headaches come less often or ease up sooner, that’s your answer on whether regular sessions are worth it.
When is a headache a reason to see a doctor instead?
Massage is for muscle-driven headaches. Some headaches have nothing to do with muscle, and a few need medical care the same day.
Get seen right away for a sudden, severe headache that peaks within a minute, a headache with fever and a stiff neck, one that comes with weakness, numbness, confusion, slurred speech or a change in vision, or a headache after a blow to the head. A new pattern of headaches that starts after 50, or one that wakes you up at night, deserves a doctor’s visit too.
One more thing that catches a lot of people out. If you’re taking over-the-counter painkillers for headaches more than about two or three days a week, the pills themselves can keep the headaches going. That’s worth bringing up with your doctor.
And if you’ve had massage and the knots keep coming right back, or your headaches turn out to be migraines, our pain practice is under the same roof. Dr. D’Alessio offers trigger point injections for stubborn knots and Botox for chronic migraines, and a massage can sit alongside either.
If your shoulders are up around your ears as you read this, book a massage with us in Montville or call (973) 794-3958.
Can I Get a Massage If I Have Sciatica?
Massage can ease the muscles that clench around an irritated sciatic nerve, if the pressure goes in the right place. When it helps, when to wait, and what to say first.
What Does a Lymphatic Drainage Massage Actually Do?
Why lymphatic drainage massage is so light, who tends to book it, when to check with your doctor first, and what happens during the hour.
Swedish or Deep Tissue Massage: Which One Should You Book?
The two massages most people choose between, explained plainly: what each one feels like, who it suits, and what to tell your therapist first.