Does massage help with migraine or severe headaches?

How many times have we intuitively placed our hands on our head to give ourselves a light massage to alleviate the pain of a headache? Physiotherapists know only too well that, depending on the type of pain – and always after consulting a doctor about the cause(s) of that pain – there are certain techniques that in some cases can help ease our suffering of a condition that can become debilitating when repeated over time. We met up with Pablo Irimia to explore this notion further. He is a specialist in the neurology department at the University of Navarre Clinic and he leads the headache study group for the Spanish Society of Neurology.

Can massage therapy relieve the pain of a migraine or severe headache?

The effect of massage therapy on migraine sufferers is controversial, although it may help people who suffer from frequent muscle contractions and who find that these muscle spasms can trigger a migraine crisis.

What care should be taken?

It must be performed by a specialist and the patient must be aware of the objectives of the therapy. Massage therapy is complementary to drugs for pain crises, such as anti-inflammatories and triptans and to the use of preventive treatments when migraine attacks are frequent.

In addition to going to the physiotherapist, could we help ourselves with self-massage?

There is no evidence that self-massage can improve migraine attacks. The action might have a certain relaxing effect and could help control certain stressful situations that might trigger a migraine crisis.

So, while a massage or self-massage might be ineffective, it wouldn't cause any worsening of the pain, right?

Self-massage of certain trigger or acupressure points could worsen a migraine attack. Migraine sufferers often have certain areas that are particularly sensitive to pain, where applying inappropriate pressure could make it easier to trigger a pain episode.

Is there any particular massage you would recommend?

Physiotherapist Daniela Toro emphasises that, if a person frequently suffers from headaches, the first thing they should do is "go to their doctor to find out what type of pain it is, where it comes from and how to treat it." She draws a clear distinction between migraines and severe headaches. In tension headaches, she explains, the pain is "bilateral, encasing the head in a tight helmet, oppressive, in the upper part of the head and also across the temples, forehead and it can even go up from the neck.

It can last between 30 minutes and 7 days, it does not get worse with physical exercise and it does not cause nausea, vomiting, photophobia or phonophobia." In migraines, the pain is usually "one-sided, pulsating, it can change from one side to the other in different occurrences, it lasts between 4 and 72 hours and it worsens with physical activity, and it can also be accompanied by feelings of nausea, actual vomiting, photophobia and phonophobia."

Daniela Toro also talks about "trigger points": "a very painful point that can be active and hurting or inactive and causing pain with stress or movement. By massaging them we can improve the pain in some cases." These are the areas to treat, but only with an expert handling it. Here is her advice:

Tilting the head, locate the upper trapezius. We then look for the trigger point that delivers radiating pain towards the centre. Using the fingertips in a pincer movement, do a light massage for 20 seconds with sustained pressure while breathing through the nose, until we notice that the radiating pain is diminishing.

Under the occipital bone at the base of the cranium there is a lot of muscle and connective tissue. "Sometimes it is tense, and to relax it, we cross our hands together and place them behind the occipital bone, as if we were sunbathing with our head resting in our hands. We extend our head and apply pressure with our hands, as if we wanted to lift our head off the torso and move it from one side to the other."

With your hand on your temple, push the head against the hand. That muscle becomes more prominent, and we grasp it in a pincer grip with both hands, moving one towards the head and the other towards the collarbone.

Place your thumbs in the eye socket area, just below the eyebrow, using light pressure and slowly slide towards the temples. As long as the pain is not too severe, you can also apply pressure outwards even from the nose.

There is a point in people who suffer from bruxism (grinding of the teeth), in the masseter area of the jaw, where if you press it, you feel radiating pain towards the eye. The expert suggests a circular massage with the fingertips, while opening and closing the mouth.