Massage and its complementary use in the treatment of Migraine, Tension Headache, Cluster Headache and Stress Induced Symptoms.

Massage and its complementary use in the treatment of Migraine, Tension Headache, Cluster Headache and Stress Induced Symptoms.


There are approximately 400,000 migraine sufferers in Ireland. I am one of those 400,000. It can often feel like there is a lack of sympathy for the condition. At present it is estimated that migraine costs the Irish economy somewhere in the region of €252 million a year through a reduction in productivity and absenteeism.

According to a study published in the Irish Medicines Journal and conducted over the course of 3 months; 227 patients out of 8759 attendances presented to one Emergency Room were by those suffering from some form of headache/migraine.

There is a difference between Migraine, Tension Headaches and Cluster Headaches.

What is the difference and what are the facts?

Tension Headache: This is the most common form of headache. It is estimated that approximately 90% of women and roughly 70% of men experience tension headaches at some point in their lives.

There causes of tension headaches are numerous, they include stress, poor posture and working in environments with inadequate/insufficient lighting. They commonly occur in the afternoon/early evening of a stressful day and they can last from one to six hours. It feels like a pressing headache that tightens down the head with a feeling of tension in the shoulders and back of the neck.

Unlike migraine, the pain tends to be on both side of the head, and there is no worsening of symptoms by routine activities. There is usually no additional symptoms – again unlike migraine.

A short term solution to tension headache is to treat with over-the-counter medication such as paracetamol, ibuprofen etc. The best long term remedy for tension headaches, is regular exercise and stress management techniques – such as massage.

Cluster Headaches: This is a rare, but sever type of headache that effects less than 1% of the population. Cluster headaches are found to be six times more common in men than women. The onset of these usually occurs in the late 20’s/early 30s.

Typically a cluster headache will begin in the middle of the night and feel like a severe stabbing pain with a duration of anywhere from 15 to 180 minutes (and often longer) impacting one side of the head. It is not always the same side of the head that is impacted, but both sides of the head are nearly always never both impacted. Symptomatically it is often described by suffers’ as “a hot poker through the eye”.

Cluster headaches can occur several times in the day with some sufferers describing attacks as lasting weeks or even months, but the time between attacks also lasting months or years.

Cluster headache differs from migraine in a significant way, one such difference is that with a cluster headache the sufferer becomes agitated during the attack and is unable to sit or lie down or find any relief with sleep.

Presently studies are investigating the use of oxygen for the treatment of cluster headaches with some success.  Massage increases the blood flow into the muscles. By increasing this blood flow, we also increase the supply of additional oxygen and nutrients to the muscles – which is crucial for relaxing the muscles.

Migraine: This is the most common neurological condition in the world. Migraine affects approximately 12-15% of the population of Ireland alone (that equates to roughly half a million people in Ireland). It appears to be three times more common in woman than with men, and is usually inherited.  Migraine is a unique condition as some people will experience only one or two attacks a year while others suffer weekly – making it a very individual condition. These attacks can last anywhere from 4-72hours.

Migraine presents as a one-sided throbbing headache which can last hour or even days. The headache can be worsened by movement or physical activity. However the headache is only one symptom of the condition. A Migraine attack can be first signalled by disruption of vision. Sufferers often describe a blurred/double vision. This is called the aura stage of the migraine but only impacts roughly 20% of migraine sufferers. The headache, and possible blurred vision, is accompanied by nausea/ vomiting, diarrhoea, sensitivity to light &noise and strong smells, confusion and in rare cases a temporary paralysis and loss of speech.

As mentioned earlier, roughly half a million people in Ireland suffer from migraine and I is estimated the impact of this to Irish business is somewhere in the regions of €252 million annually as a result of loss of productivity and with the average migraine sufferer missing between 1.5 and 4.5 days from work. All age groups suffer from migraine with women three times more likely to suffer. There seem to be no common thread linking all sufferers of migraine, as trigger factors are highly individual.

 Some triggers outlined by sufferers of migraine include sleep deprivation or disturbances, increases in stress or anxiety and long periods in front of a computer screenresulting in postural changes – to name but a few.

Massage can assist with the triggers highlighted above. Massage promotes better sleep patterns and thereby improves the quantity and quality of sleep. Migraine will cause the sufferer to be in a high tension/poor postural state trapping tension in the neck, shoulders and upper back. Massage eases the tension trapped in these areas results in a decrease in tension and stress experienced by the sufferer. With a decrease in tension in the areas of neck, shoulders and upper back, a return to correct posture is experienced.

Effect of Posture (Here comes the Science)

This is a bit of a chicken & egg scenario. Does headache/migraine cause bad posture or does bad posture cause headaches.  When a headache/migraine attacks it is easy to reach for the over-the-counter medication and focus on making the pain dissipate for a short period of time. By taking the time to consider the impact of posture on headache/migraine you may be saving yourself countless attacks in the future as well as saving yourself money from buying all that over-the-counter pain medication.

Within the 47% of a global population that experiences headache/migraine, 15-20% of these attacks are caused by a postural dysfunction in the neck (cervicogenic). As a result of this 44 % of people with cervicogenic headaches, also experience jaw pain (the big word name for this is temporomandibular joint (TMJ) pain).

Forward head posture (FHP - also known as kyphosis) is more common than you’d think. To describe how this would look – it is when the head is in a forward position ahead of the shoulders. With the head in this position, it changes the centre of gravity of the person, resulting in an increase in tension on the neck, and those muscles associated with its structure and support. With this forward head position, the upper neck (cervical) extends in order to maintain a line of vision. This results in a shortening of posterior cervical muscles. As a result of this increased tension there is a repeated stimulus of pain into the nerve of the face and jaw (trigeminal nerve nucleus). If this goes untreated, there is a lowering of the sufferers’ pain/discomfort threshold – the body begins to think this new posture is ‘normal’, resulting in an increase in the frequency of headaches.

Common Causes of FHP: include injury or muscle guarding, muscle tension or muscle weakness, stress, genetics, improper shoes (believe it or not) and occupations that involve prolonged sitting. Bad postural habits are also a key influencer in causing FHP ad as a result headache/migraine.

What can be done: By relieving the tension and adhesions associated with poor posture, a headache/migraine sufferer will experience immediate relief. As a Sports Massage Therapist, we aim to reduce the symptoms associated with headache/migraine. In addition to Massage Therapy, a client specific mobility and strength programme can be developed for improving the muscles of the neck. Furthermore a client specific programme can be developed to improve the sufferers posture.

If you wish to discuss your symptoms further you can book your appointment today by popping into us in CityGym Limerick. You can also call The Muscle Manageron 085-704 5157, or email us on

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