Tension Headache is a muscle contraction type of headache, often in the pattern of trigger point referrals. The headache is of muscular origins, associated with trigger points and other myofascial pain syndromes.
Tension Headache Massage Therapy Treatment Goals:
- Decrease: SNS firing, pain, hypertonicity, trigger points, joint dysfunction.
- Increase: ROM and circulation Tension headache massage technique
Tension Headache Massage Treatment:
- Diaphragmatic breathing Tension heada che massage technique
- If prone is tolerable, upper back and shoulder treatment ( MFR, effleurage, petrissage)
- Head, neck and shoulder massage – focus on muscles outlined in referral patterns
- May use Hot hydro to affected muscles before the treatment
- Supine or sidelying with soothing techniques
- Effleurage, stroking, fingertip kneading to pectoralis and posterior neck (upper traps, levator scapula)
- Petrissage on the muscles of mastication ( medial and lateral pterygoid, masseter and temporalis), facial muscles and the scalp
- Pain free joint play on hypomobile areas of the cervical spine
- Ischemic compressions (Trigger Point) treated with Deep Muscle Stripping ( to the neck including the suboccipitals) after warming them up
- post isometric relaxation to increase ROM to neck
- PROM of C/S Tension headache massage technique
- Gentle long axis traction
- GTO to occiput Tension headache massage technique
Trigger point Referral patterns for Head and Neck:
- Upper trapezius – refer above eye, around ear, down lateral neck, in a question mark Pattern
- Splenius capitis – refer to top of head
- Splenius cervicis – refer to temporal area and back of neck
- Occipitalis – refer to post and sup. Head
- Frontalis – refer locally above eye
- Suboccipitals – refer pain from temporal region to above ear, in a band to post head
- Sternocleidomastoid – refer to occiput, around eye, into ear and across forehead
- Temporalis – refer to temporal region and teeth
- Masseter – refer above eye, into ear, jaw and teeth
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Considerations/ Contraindications for Tension Headache Massage Therapy Treatment:
- avoid deep work when headache is present
- all treatment within pain tolerance
- avoid vigorous techniques or deep pressure to avoid kickback pain
- do not do ischemic compressions too quickly.
- Follow Ischemic compressions with PROM
Signs and Symptoms for Tension Headache:
- pain is bilateral and constant, in referral pattern of trigger points
- muscle tenderness, stiffness, hypertonicity
- loss of appetite if pain is bad enough
- if SCM is involved may have nausea, vertigo, and tinnitus (ringing in ears)
- aggravating factors include stress, fatigue, cold, poor posture, decreased ROM
- during headache, person wishes to rest, mild disability
- postural dysfunction, TMJ dysfunction
- there is often a family history Tension headache massage technique
Self Care for Tension Headache:
- rest after Trigger point treatment
- hot bath, hot hydro to affected muscles
- diaphragmatic breathing
- self massage
- slow, full, pain free stretching, and Active Free Range of Motion
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