Massage for tension headaches and a tight neck.

Massage can ease tension-type headaches and neck tension for some people, mainly by calming tender muscles in the neck, shoulders and jaw. The research is mixed, and regular sessions did better than single visits.

• Best suited to tension-type headaches and headaches that start in the neck.
• In a 2015 trial, massage made tender neck muscles less sensitive, and people reported more relief than with a fake treatment.
• A 2024 Cochrane review found little effect on neck pain overall, with better results at 8 or more sessions over four weeks.
• A sudden severe headache, or a headache with weakness, fever or confusion, needs 911.
• Massage works best with posture changes and exercises.

Tension-type headache feels like pressure or a tight band around the head, often on both sides. Many people with it also have tight, tender neck and shoulder muscles.

Some of those tender spots refer pain. Pressing on a spot in the upper shoulder or under the skull can bring on the same ache you feel behind your eye or across your forehead. Researchers call these spots trigger points. Long hours at a screen, driving, stress, jaw clenching and poor sleep all keep these muscles working when they should rest.

The session usually covers:

• The upper shoulders and the muscles up the side and back of the neck.
• The small muscles at the base of the skull.
• The jaw and temple muscles, for people who clench or grind.
• The chest and the muscles between the shoulder blades, which affect how the head sits.

Kevin checks which tender spots reproduce your usual headache and spends time there with steady pressure, slow strokes and gentle stretching. Neck work is done lying down, with your head supported.

For headaches, a 2015 trial in the Clinical Journal of Pain gave 56 people with tension-type headaches either 12 sessions of neck and head massage over six weeks, a fake treatment, or no treatment. Headache frequency fell in both the massage and fake treatment groups, which shows how strong expectation is in headache studies. People in the massage group reported more improvement in their headache pain, and their tender neck muscles became less sensitive to pressure. The fake treatment group did not show that change.

A 2014 review in the Journal of Headache and Pain found six trials on chronic tension-type headache, one using massage and five using physiotherapy. The authors judged both to be useful options.

For neck pain, the 2024 Cochrane review pooled 33 studies with 1,994 people. Against a fake treatment, massage made little to no difference to pain up to 12 weeks, and the evidence was low certainty. When the authors grouped trials by dose, people who had at least 8 sessions over four weeks, each 30 minutes or longer, showed a difference large enough to matter.

Fair reading: massage helps some people with headaches and neck tension, regular visits matter, and the effect is bigger when massage sits next to exercise and changes at your desk.

Some headaches are emergencies. Get help at once for:

• A sudden, severe headache that reaches full strength within a minute.
• A headache with fever and a stiff neck.
• A headache with weakness, numbness, confusion, trouble speaking or loss of vision.
• A headache after a blow to the head, or one that keeps getting worse after a crash.
• A new kind of headache, or a change in your usual pattern.

The last two need a doctor or our concussion team before massage. For the first three, call 911 or go to Lions Gate Hospital emergency.

• Take regular short breaks from the screen.
• Set your screen at eye level and your keyboard close to your body.
• Do slow neck turns and shoulder rolls a few times a day.
• Notice jaw clenching and let your teeth rest apart.
• Keep a headache diary so you and your therapist can see what changes.

For neck pain that limits turning, a physiotherapy assessment for neck pain adds joint work and exercises. Read more on our headaches page. After a crash, see headaches after a crash.