A vice. A clamp. A tight band wrapped firmly around your head. The pressure is building and it feels as though your head might explode! Tension headaches can be unbearable and, at times, utterly debilitating. We describe the signs and symptoms of tension headaches, explore their underlying causes, and explain how remedial massage can help reduce their severity, duration and frequency.
What are the sign and symptoms of tension headaches?
Tension headaches typically produce a strong constant pain or pressure on both sides of the head or forehead, with pain sometimes radiating down into the neck, shoulders, and arms. The pain is often described as a dull persistent ache. In most cases, they are mild to moderate in severity and occur infrequently.
On the other hand, some people experience severe tension headaches and are tormented by them as often as 3 to 4 times a week. When headaches occur more than 15 times a month, they are classified as “chronic tension headaches”. The intense pain of a tension headache may be confused with a migraine. Unlike migraines, however, tension headaches do not typically produce nerve symptoms such as visual disturbances, sensitivity to light and noise, blurred vision, slurred speech, stomach pain, nausea and vomiting, or preceding numbness/weakness of the arms or legs.
New worsening headaches that are unfamiliar should always be discussed with your doctor. Likewise, headaches associated with fever, stiff neck, confusion, seizures, double vision, weakness, numbness, slurred speech, or that are sudden and intense at onset should prompt emergency department presentation.
What are the causes of tension headaches?
Previously termed muscle contraction headaches, tension headaches are thought to be muscular in origin and associated with mental stress. When muscles are locked into position for a long period of time (think of yourself stuck at a desk almost all day), there is inadequate blood supply to the neck, shoulders and upper back muscles. This in turn generates trigger points (hyperactive contractile regions of a muscle compared with the surrounding tissue), leading to referred pain in the form of a headache! In addition to this, stress, anxiety, depression and conflict are also thought to be contributing factors of tension headache. This is because psychological tension has a knock-on effect and causes muscles to contract and tighten.
How can remedial massage help?
Remedial massage can help relieve tension headaches by releasing overly tight head, neck and shoulder muscles through trigger point therapy and stretching exercises. Trigger point therapy works by applying sustained pressure to those sensitive sore spots of the muscle. This helps to increase blood flow to the area, thereby allowing necessary nutrients to relax the muscle fibres. It can feel uncomfortable and even produce headache-like symptoms due to referred pain, however this usually lasts no more than 1 to 2 minutes. Stretching compliments trigger point therapy by lengthening shortened muscle fibres, thereby increasing flexibility, improving range of motion, and ultimately reducing pain and stiffness. Massage therapy not only helps the muscles of the body to relax, but also effectively reduces mental stress that can cause or exacerbate headaches.
A significant and meaningful reduction in tension headache frequency and duration was observed in one study where sufferers received regular head and neck massage. The participants received half-hour massages twice a week for 4 weeks following a baseline period of 4 weeks with no treatment. The study found headache frequency was reduced within 1 week of massage treatment compared with baseline levels and was maintained during the 4 weeks of massage treatment. A reduction in the average duration of each headache was also noted. The researchers concluded that massage therapy was an effective non-pharmacological intervention for the treatment of chronic tension headache.
Arendt-Nielsen, L., Castaldo, M., Mechelli, F., & Fernández-De-Las-Peñas, C. (2016). Muscle Triggers as a Possible Source of Pain in a Subgroup of Tension-type Headache Patients? The Clinical Journal of Pain. https://www.ncbi.nlm.nih.gov/pubmed/26550960
Bendtsen, L., Ashina, S., Moore, A., Steiner, T.J. (2016). Muscles and their role in episodic tension-type headache: implications for treatment. Eur J Pain. https://www.ncbi.nlm.nih.gov/pubmed/26147739/
Chaibi, A., & Russell, M. (2014). Manual therapies for primary chronic headaches: A systematic review of randomized controlled trials. The Journal of Headache and Pain.
By Liz Darrington, Remedial Massage Therapist Coffs Harbour