In this third installment on headaches, we’ll be discussing how massage and trigger point therapy to key muscles in the neck and face can help diminish the effects of a headache.

Massage

If you consider the fact that 90% of all headaches are tension related in some way, then reducing tension levels, whether it be physical or psychological, should provide relief for a vast majority of people. Even those suffering from chronic migraines, cluster headaches, and new daily persistent type headaches are greatly affected by excessive tension in the muscles of the head and neck. It’s no secret that maintaining a healthy lifestyle with a balanced diet, plenty of exercise and sleep will go a long way in reducing stress levels. There may however be other factors at play that could be contributing to your headache. Factors such as postural imbalances, repetitive movements, strained sleeping positions, cervical arthritis, or even whiplash – all of which could be at the root of tight muscles. The one thing all these factors have in common though, are trigger points. Trigger points develop in strained or chronically tight muscles and are often the hidden and undetected cause of most headaches. There are close to 26 pairs of individual muscles in the neck and over 30 pairs of muscles in the face, all of which could be harboring trigger points! The work of Travell & Simons has shown that trigger points are the ‘operational element’ in most headaches stemming from physical trauma and emotional tension. The irony however, is that most headaches arise from trigger points found in the jaw, neck and upper back muscles! Knowing this saves a lot time and energy, but it also allows for a more focused and effective treatment plan. Now, let’s take a look at the key players.

There are four primary muscles in the head and neck that refer pain to the temples, forehead and jaw, and play a significant role in the development of headaches. The first two muscles, the trapezius and the sternocleidomasoid (SCM), are considered neck muscles (segments of the trapezius are also considered upper back and shoulder muscles). The other two, masseter and temporalis, are jaw muscles and are located on the face and head.

Trapezius:

Trapezius Trgr PtThe trapezius is a flat, broad upper back muscle that functions to move the neck and shoulders. It also helps to support the weight of the head and is therefore particularly susceptible to postural imbalances, which can put undue strain on the muscle. A trigger point in the upper part of the trapezius is one of the primary causes of temporal headaches. The referral pattern of this trigger point includes the back of the head, sides of the temple, and angle of the jaw. It’s also been known to setup up satellite trigger points in these areas, which can lead to a deep pain behind the eye, toothaches, and TMJ. Stress and emotional tension can often keep this muscle constantly contracted and elevated on some people — as can wearing a heavy backpack or purse, a forward head posture, or tight pectoral muscles. Trigger points in the middle and lower half of the traps will often refer pain to the back of the neck.

Sternocleidomastoid (SCM):

SCM Trgr PtsThe sternocleidomastoid muscle, or SCM for short, derives its name from its points of attachment. The two branches of the muscle attach on the sternum, clavicle, and mastoid process — which is located behind the ear. Although these muscles rarely hurt themselves, trigger points found in the SCMs are usually at the root of frontal headaches and pain located on the face. This muscle serves several purposes. Much like the upper traps, it functions to rotate and laterally flex the head to the side, and is an accessory breathing muscle — helping to elevate the ribcage during inhalation. Its very functions however, make it susceptible to postural imbalances such as, a forward head posture, and shallow upper respiratory breathing arising from emotional and/or psychological tension. Triggers points in the SCM can also be a leading cause of a painless, stiff neck; a deep pain behind the eye, ear, and back of the head; tongue pain when swallowing; and a contributing factor in TMJ pain. Unfortunately these muscles are rarely worked on, despite their wide and primary effects.

The other two muscles are located on the head and face. Masseter is a chewing muscle found along the angle of the jaw, which provides the jaw with most of its power. Trigger points in masseter can restrict the opening of the jaw and lead to pan in the upper and lower teeth. It’s also one of the leading factors in the development of TMJ. Its referral pattern includes many points on the face such as, the cheek, above the eyebrow, along the jaw, deep in the ear, and can on occasion mimic the symptoms of sinusitis. Pain arising from masseter trigger points can be an underlying cause of frontal headaches. Temporalis, like masseter, is a chewing muscle. This flat muscle is located on the sides of the head just above the ears. Trigger points in temporalis refer pain to the area above the eyes and upper lips. They contribute to the formation frontal and temporal headaches and can sometimes lead to hypersensitivity in the upper teeth.  

Another set of muscles worth mentioning are the suboccipitals. These two pairs of four, short, individually named muscles are located at the base of the head and the very top of the neck. Pain from trigger points in the suboccipitals can feel like a band of tightness inside the head, starting at the back of the head and leading to the eye and forehead. This type of pain is commonly associated with migraine headaches. The suboccipitals are particularly vulnerable to emotional tension, as well as the effects of satellite trigger points coming from the trapezius. Research has discovered that one of these short muscles not only attaches to the occiput, but to the dura mater – the connective tissue that covers the brain. In light of this connection, it’s speculated that increased tension in this muscle can disrupt the normal fluctuations of cerebrospinal fluid and lead to headaches.

In some cases, focused work on these key muscles alone can have the added benefit of deactivating satellite trigger points that fall in their referral patterns. However, this is not always the case, especially in the more severe and long-term cases. The cascading effects of trigger points are one of the main reasons why some of them are so persistent and easy to miss. But once they are systematically treated and deactivated, relief is usually not far behind.

In the next and final post, we’ll see how reflexology to particular reflexes found in the hands and feet can help with headaches.


joe-azevedo2Joe Azevedo is a New York State/NCBTMB Licensed Massage Therapist, ARCB Certified Reflexologist, and an Advanced Reiki Practitioner. He is a graduate of the Swedish Institute and is the owner and founder of Brooklyn Reflexology.