To complement the Research Reports in the September 2016 issue of MASSAGE Magazine.

woman needs headache help


Headache frequency, the pain-pressure threshold of certain myofascial trigger points and perceived change in headache pain all improved following 12 sessions of myofascial trigger-point massage applied to the head and neck, according to recent research.

The study, “Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled trial,” involved 56 people suffering from two or more headaches per week.

In order to be included in the study, subjects’ headaches had to meet the criteria for tension-type headache (TTH) as defined by the second edition of the International Classification of Headache Disorders: head pain of bilateral location, pressing or tightening quality, mild to moderate intensity and not aggravated by routine physical activity.

Study participants were randomly assigned to one of three groups: a myofascial trigger-point massage group, a placebo detuned ultrasound group or a wait-list group. The 12 massage and placebo sessions each lasted 45 minutes and took place twice a week during a six-week period.


Protocol for the Massage Group

The massage protocol began with 15 minutes of myofascial release applied to the back, shoulders, chest and neck. Next, the massage therapist performed 20 minutes of trigger-point release bilaterally to address myofascial trigger points in the upper trapezius, the sub-occipital muscle groups and the sternocleidomastoid muscles.

“The upper trapezius, sub-occipital muscles and the sternocleidomastoids were selected for [trigger point release] treatment due to the high frequency of [myofascial trigger points] in these muscles that refer pain to the head and reproduce the subject[’s] headache pain complaint,” stated the study’s authors.

The last 10 minutes of each massage session consisted of “post-isometric relaxation directed at right and left lateral cervical flexion, circular or cross-fiber friction on the masseter, temporalis and occipital-frontalis muscles, as well as gentle effleurage and petrissage to neck and shoulders.”


Outcome & Results: Did Massage Provide Headache Help?

The main outcome measure for this study was headache pain, which focused on frequency, intensity and duration. These factors were recorded in a daily headache diary. Secondary outcome measures included the pressure-pain threshold of myofascial trigger points in the upper trapezius and sub-occipital muscles, along with self-reported perceived change in headache pain.

Results of the research revealed that headache frequency decreased from baseline for subjects in both the massage and the placebo groups. As for participants’ perceived change in headache pain, there was a greater perceived reduction in headache pain among those in the massage group as compared to those in the placebo and wait-list groups. The pressure-pain threshold of myofascial trigger points in the upper trapezius and sub-occipital muscles improved only in the massage group.


About the Study

Authors: Albert Moraska, Lea Stenerson, Nathan Butryn, Jason Krutsch, Sarah Schmiege and J. Douglas Mann.

Sources: College of Nursing, Department of Anesthesiology, School of Medicine, University of Colorado, Denver, Colorado; Boulder College of Massage Therapy, Boulder, Colorado; Department of Neurology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina. Originally published in February 2015 in the Clinical Journal of Pain, 31(2), 259-168.