Massage for headaches originating in the neck

Many headaches, especially those which are one-sided, are caused by neck tension or problems with the cervical spine. The technical term for this is a cervicogenic headache. The pain is actually referred from the neck to the head. They are often accompanied by neck stiffness, and even pain in the shoulder and arm. Because trigger points, adhesions, and muscle spasms in neck muscles often cause headaches, I have had good luck using massage and craniosacral treatments. Now research is beginning to provide evidence that massage helps, but before I talk about the research I want to back up a step.neck massage

How did the neck become so bad to begin with? It might be the result of an injury, such as whiplash. There could be scar tissue, or damage to the spine itself, such as compressed disks, arthritis, deteriorated vertibrae, and spinal stenosis, which have caused the muscles to spasm and develop trigger points. Massage can’t do anything about many of these conditions. However, poor posture is a very common reason for neck problems, and that can be fixed. Sometimes it takes a great deal of time and effort to do postural retraining and core strengthening, but a determined person can change long-ingrained habits. Massage can help with that, but that’s a subject for another post.

According to a recent review paper, there is little evidence that conventional treatment for cervicogenic headache (medication,  nerve blocks, facet joint injections, surgical procedures such as fusions, etc.) works [1]It can be costly and frustrating to try a series of these treatments, without any benefit.

For centuries, if not millenia, people have used massage as a safe and effective way to relieve neck tension and pain. Now, a pilot study of eight people indicates that it really can help [2]. The authors measured neck mobility before, right after and two weeks after an eight-minute massage (only eight minutes, come on!). They found significant increase (from 27.5° to 45.9°) in rotation after three treatments, and no significant regression after two weeks.

While that study only looked at improvement in neck mobility, another study published in 2013 found that massage combined with appropriate exercise (2x/wk for 6 wks) helped relieve headaches[3]. Although those authors found that cervical manipulation combined with exercise did more than massage, many of my clients do both and have faster results with the combined therapies. Not everyone is willing to get chiropractic treatments, so massage with exercise remains a viable option.

One obvious problem with both of these studies is the lack of a control group, perhaps one which only does exercise, does acupuncture, or takes muscle relaxants. Since massage research is still in its infancy, and a pilot study only looks at feasibility, we’ll have to wait on better research to say more.

I’m currently accepting new massage clients at my clinic in Bend, Oregon. To make an appointment, or ask questions, phone me at (541)350-1613, or email at

[1] Therapeutic options for cervicogenic headache, César Fernández-de-las-Peñas  and María L Cuadrado, Expert Review of Neurotherapeutics, January 2014, Vol. 14, No. 1 , Pages 39-49
[2]A pilot study to investigate the short-term effects of specific soft tissue massage on upper cervical movement impairment in patients with cervicogenic headache, Dianna Hopper, et. al, Journal of Manual and Manipulative Therapy, Volume 21 Issue 1 (February 2013), pp. 18-23
[3]Mobilization versus massage therapy in the treatment of cervicogenic headache: A clinical study, Enas F. Youssef and Al-Sayed A. Shanb, Journal of Back and Musculoskeletal Rehabilitation, Volume 26, Number 1 (January 2013), pp. 17-24


About Ann

Ann Stanley has practiced massage and craniosacral therapy in Bend Oregon for the past nine years. She incorporates myofascial release and lomi-lomi techniques into her massage. She is writing a novel, plays the flute and piano and has a Ph D in applied mathematics. She did research for many years on mathematical models for the spread of infectious diseases, first at Los Alamos National Laboratory and then at Iowa State University.
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