Headaches and migraines are among the most common reasons clients seek manual therapy. While they can be complex and multifactorial, many types, particularly tension-type and cervicogenic headaches, respond remarkably well to skilled remedial massage. This guide delves into the anatomical understanding and practical techniques required to effectively assess and treat clients suffering from these debilitating conditions.

Differentiating Headache Types: The Role of Assessment

A thorough initial assessment is crucial to determine if massage is an appropriate treatment and to tailor your approach. For headaches, the source can often be found in the musculoskeletal system of the neck and head.

• Tension-Type Headaches: These are typically bilateral and feel like a tight band around the head. They are often linked to muscular tension in the neck, shoulders, and scalp.

• Cervicogenic Headaches: This type of headache is unilateral (one-sided) and originates from a dysfunction in the cervical spine or its surrounding soft tissues. The pain is usually referred from the neck and suboccipital region.

• Migraines: While migraines have a neurological component, muscular tension can be a significant trigger and an effective target for manual therapy. A client assessment helps determine if muscle tension is a likely trigger.

Targeted Techniques for Cranial and Cervical Release

For both tension-type and cervicogenic headaches, the focus of your treatment should be on releasing tension and improving circulation in the muscles of the head, neck, and upper back.

Suboccipital Release

The suboccipital muscles at the base of the skull are frequently implicated in both headache and neck pain. Apply gentle, sustained pressure with your fingertips to this area. This technique aims to release deep tension and decompress the upper cervical vertebrae.

Releasing the Sternocleidomastoid (SCM)

Tension in the SCM can contribute to pain that refers to the face, temples, and forehead. Work carefully along the length of this muscle, using a gentle pincer grasp to release localized areas of muscular spasm.

Myofascial Release for the Upper Trapezius and Scalenes

Tightness in the upper trapezius and scalenes can directly refer pain to the head. Utilize myofascial release techniques to address fascial adhesions in these muscles. For a deeper understanding of this modality, see our article on  Advanced Myofascial Release Techniques for Neck and Shoulder Pain

A Holistic Approach for Lasting Relief

While your in-clinic work is essential, client education is key to preventing the recurrence of headaches and migraines. Advise clients on proper posture, particularly for those who spend time at a desk, and suggest simple stretches for the neck and upper back. This comprehensive approach, combining targeted treatment with empowering homecare advice, provides the best chance for long-term relief. For a complete guide to treating a wider range of conditions, see our article on The Remedial Therapist's Comprehensive Guide to Chronic Lower Back Pain.