Tension headaches and migraines often trace back to tight muscles in the neck, shoulders and jaw rather than the head itself. Registered massage therapy releases the trigger points in the suboccipitals, upper trapezius and jaw muscles that refer pain upward, and research supports massage as a way to reduce the frequency and intensity of tension-type headaches over time.
Quick summary
- Most tension headaches originate in the neck, shoulders and jaw — not in the skull itself.
- RMT massage releases the specific trigger points (suboccipitals, trapezius, SCM, jaw) that refer pain into the head.
- Migraines have a neurological component massage cannot cure — but muscular contributors can be addressed.
- New, severe or changing headaches need physician assessment before massage.
- A short series of treatments (weekly or bi-weekly) typically produces more lasting change than a single session.
Can massage therapy really help with headaches?
For tension-type headaches, yes. The International Headache Society classifies tension headaches as the most common headache type, and in clinic they’re the kind we see constantly: a dull band of pressure that builds over a workday, tied to a tight neck, hunched shoulders, eye strain, and stress that nobody has let go of since Monday. Those are muscular and postural problems, and they’re squarely what a registered massage therapist works on.
Here’s the part most people don’t expect. The pain usually isn’t coming from where you feel it. Tight muscles develop trigger points, hyper-irritable spots that hurt locally but also send pain somewhere else entirely. The suboccipital muscles, four small muscles tucked at the base of the skull, are the classic culprit: when they stay clenched, they produce a band of ache across the forehead or a deep pressure behind the eyes that feels for all the world like a headache. Press the right spot at the base of the skull and a client will often say “that’s it, that’s exactly where my headache lives” — except the muscle is two inches lower than the pain.
Massage eases that tension by improving local circulation, lengthening shortened fibres, and quieting the nervous system’s pain signalling. Systematic reviews have found massage therapy can lower tension headache frequency and intensity. The evidence quality varies, and the better results come from a series of treatments, not a one-off.
A note on migraines. Migraines run on a neurological process, and no amount of massage reverses that. But plenty of people who get migraines also carry hard muscular tension through the neck, shoulders and jaw, and easing those physical contributors can cut how often and how hard attacks land. Treat massage as support that sits alongside whatever your physician prescribes, not a substitute for it.
One firm line: if your headaches are new, suddenly far worse than your usual, or come with any neurological symptoms — vision changes, weakness, confusion, fever — see your physician before you book a massage. That gate holds no matter what you think is behind them.
What is the difference between a tension headache and a migraine?
The distinction isn’t academic. It changes how your RMT works with you.
A tension-type headache usually feels like a dull, pressing band around the whole head, both sides, moderate in intensity, and it doesn’t get worse when you move around. Muscular and postural factors drive it, which is exactly why hands-on treatment helps.
A migraine is a neurological disorder, full stop. It often sits on one side, throbs rather than presses, and brings company: nausea, sensitivity to light, sometimes visual disturbance (aura). There’s a genetic thread, and the underlying mechanism is changes in brain chemistry and blood flow that no massage touches. What massage can reach is the neck tension many migraine sufferers carry, and that tension can lower the threshold for an attack. That’s the lever we work with.
Then there’s the muddle in the middle. Cervicogenic headaches, which start in the joints and muscles of the neck, get mistaken for tension headaches and migraines all the time. An RMT can read the muscular and postural picture and, when something sits outside our scope, refer you on. The College of Complementary Health Professionals of BC (CCHPBC) sets that scope. Diagnosis stays with your physician.
Which muscles cause headaches, and how do RMTs treat them?
The neck-shoulder-jaw chain is where referred head pain almost always starts, and it’s the map a headache-focused RMT session works from.
Suboccipital muscles. Four small muscles at the base of the skull link the top of the spine to the skull. Hours of screen time, a forward-head posture, or stress clenching shorten them, and once tight they compress the greater occipital nerve and refer pain up the back of the head and behind the eyes. Sustained compression release and myofascial work here often shifts head pain within the session.
Upper trapezius and levator scapulae. These two run from the neck down to the shoulder blade. A trigger point in the upper trapezius classically refers up the side of the neck and into the temple. If you sit at a desk most days, you almost certainly have active trigger points here, whether you’ve noticed them or not. If you’re travelling in from Mount Pleasant, the #9 Broadway connects to the #10 Granville, which runs south past the clinic.
Sternocleidomastoid (SCM). The thick rope of muscle down each side of the neck, running from behind the ear to the collarbone. SCM trigger points refer into the forehead, around the eye and across the cheek, which is why people describe the result as sinus pressure or a “weird eye headache.”
Temporalis and masseter (the jaw muscles). Clenching and grinding (bruxism) overload the temporalis, the fan-shaped muscle on the side of the skull, and the masseter over the cheek. Both refer straight into the head and teeth. If jaw tension is part of your picture, your RMT may raise whether our TMJ massage focus belongs in the plan.
A typical session blends direct trigger-point release, myofascial work across the upper back and neck, gentle cervical traction, and some attention along the scalp. We match the intensity to the day. On an active headache day the work stays lighter and more systemic; when you’re symptom-free, that’s when deeper tissue work earns its keep.
How is jaw tension connected to headaches?
The jaw and the head share wiring. The trigeminal nerve, the main sensory nerve of the face, branches to both the jaw muscles and the scalp, so tension in one place really does register as sensation in the other. They’re hard to treat as separate problems because the body doesn’t keep them separate.
Clench at night and you’ll often wake with a headache. The temporalis spends eight hours holding a clenched jaw, and by morning it’s a tight, tender band across the sides of the head. An overloaded masseter refers into the cheekbone, the upper teeth and the temple, in a pattern people swear is a sinus headache until you palpate the muscle and the picture changes.
Intraoral massage of the pterygoid muscles inside the cheek — gloved, and only with your consent — reaches jaw tension that external work simply can’t. It’s within the RMT scope of practice in BC, and the Cascade team does it regularly, usually paired with a TMJ assessment. Our page on headache and migraine massage goes deeper on how we combine the two.
How many sessions does it take to see results?
That depends on the person, the headache type, and how long the pattern has been running. One session can ease tension and take the edge off the pain, especially with an acute tension headache. For someone stuck in weekly or near-daily headaches, the research on massage tends to show meaningful drops in frequency building over a course of four to eight sessions, weekly or bi-weekly to start.
Once that opening phase has done its job, most people move to monthly maintenance, which is usually enough to keep the tension from rebuilding to the point where it triggers headaches again. Your RMT reads how you respond over the first couple of visits and adjusts the plan from there.
What doesn’t work is one deep session every few months, booked only once the headache is already bad. By then the muscles have been tight long enough to sensitise the nervous system, and walking that back takes more than a single visit.
Ready to get started? Book online with our South Granville RMT team — 30, 45, 60 or 90-minute sessions available. You can also browse our full range of treatments on the services page or read about our conditions we treat.
Frequently asked questions
Yes. Tension headaches are frequently linked to tight muscles in the neck, upper back and jaw. Registered massage therapists work on these areas to release trigger points and reduce muscle tension, which can lower the frequency and intensity of tension-type headaches. Massage does not cure headaches — if yours are new, severe or changing, see your physician first.
Massage may help some people who experience migraines by addressing muscular contributors — particularly neck and suboccipital tightness — that can trigger or worsen attacks. It is not a cure for the underlying neurological condition. People with migraines should work with their physician and consider massage as a complementary support alongside any medical treatment.
The most common targets are the suboccipital muscles at the base of the skull, the upper trapezius, levator scapulae, sternocleidomastoid (SCM), and the temporalis and masseter muscles of the jaw. Tightness in any of these can refer pain into the head and temples.
There is no universal number. Many people notice some reduction in tension after one or two sessions, but lasting change in headache frequency typically comes from a series of treatments spaced weekly or bi-weekly, combined with addressing contributing factors like posture, stress and screen time. Your RMT can suggest a realistic frequency at your first appointment.
See a physician before booking massage if your headaches are: sudden and unusually severe (‘thunderclap’), new and different from your usual pattern, accompanied by fever, stiff neck, visual changes, weakness or confusion, or if they follow a head injury. These may indicate a medical condition that requires assessment first.
Related: How Often Should You Get a Massage? An RMT’s Honest Answer | Massage Therapy for Lower Back Pain: What Actually Helps
Questions? Email us at hello@cascademassagetherapy.ca or call 778.788.6695. We’re at 201-3077 Granville St, Vancouver — inside Envision Physiotherapy.