Treating Tension Headaches Through Massage Therapy, Research Paper Example

Headaches are one of the most common medical ailments that health care workers are confronted with. Both the cause of, and the treatments for, headaches can be complicated and difficult to ascertain. One of the most common types of headaches is generally referred to as a “tension headache.” For many years, researchers believed tension headaches were caused by over-contraction of the muscles in the head and neck, though this standard viewpoint has recently been the subject of scrutiny. Studies have indicated that patients suffering from tension headaches did not exhibit signs of muscular contraction at rates significantly higher than in subjects without headaches; some research has shown that, like migraine headaches, tension headaches may be linked to serotonin production in the brain[i]. Despite new evidence that the name “tension headache” may be somewhat misleading, there have been numerous studies demonstrating that massage therapy can provide effective relief of tension headaches for a statistically significant number of patients. This discussion will present an overview of tension headaches as well as a proposed treatment plan for the application of massage therapy as a means of providing relief from tension headaches.

As noted, determining the cause of tension headaches has proven to be difficult. While many sufferers of tension headaches do exhibit muscle tension in the neck and head, many others do not[ii]. Researchers have concluded that when such muscle tension is present along with the pain associated with tension headaches, that stiffness is most likely a symptom itself, as opposed to being the cause of the headache[iii]. Further complicating this issue is the fact that among the various factors believed to contribute to tension headaches, poor posture and the straining of neck muscles –such as may be seen in someone who sits at a computer for long periods- would seem to indicate that muscle over-contraction is a possible cause[iv]. For researchers attempting to make sense of this seeming contradiction, some have concluded that the fatigue and anxiety associated with such tasks contribute both to the headache and to the muscle contraction[v].

There are many different factors that are believed to contribute to tension headaches. Along with the aforementioned posture issue, other factors like smoking, the use of alcohol, poor dietary habits, and a lack of exercise are all believed to be possible causes of tension headaches[vi]. Because the etiology of tension headaches can be so elusive, many physicians and other health-care workers recommend that sufferers keep a “headache diary” in which they track such things as when and what they eat, exercise habits, the use of tobacco, alcohol, and medications, and any other parts of their daily routines that may contribute to headaches[vii]. This allows both patient and health-care provider the opportunity to look for links between any of these factors and the onset of headaches; when possible, the patient can eliminate those things that may be causing headaches in an effort to determine if such an elimination is helpful.

Health-care providers offer a range of different treatments for tension headaches, from the use of analgesics and anti-inflammatory medications to the use of biofeedback, yoga, and massage therapy[viii]. The applications of these various therapeutic approaches have shown a statistically significant rate of efficacy, with some treatments working better than others for different patients. Despite the seeming lack of a causal link between muscle tension and tension headaches, massage therapy has proven to be one of the more effective non-medical treatments for tension headaches; in studies, some subjects have demonstrated improvements in the frequency and severity of their headaches for months after treatment[ix].

A study conducted in 2002 attempted to determine the efficacy of massage therapy form tension headaches, ands looked at specific techniques such as myofascial trigger-point massage and the focused application of pincer and palpation techniques in areas where over-contracted muscles were present. The study was conducted over a ten-week period; each subject had two sessions per week with a licensed massage therapist. The protocol for the sessions was quite specific, and the therapists were instructed to adhere strictly to that protocol. As the researchers explained it to the therapists, their task was not to treat the subjects’ headaches, but to perform the protocol accurately. With each therapist performing the same protocol, and each subject receiving the same number and type of treatments, the researchers believed they could acquire useful data.

The results of the study (and others like it) were conclusive: the use of massage therapy to treat tension headaches proved to be quite effective[x]. The study began with a four-week “baseline” period; during this time the subjects were told to continue using whatever pharmacological treatments they normally used, but to refrain from chiropractic treatments or massage therapy. This baseline period allowed researchers to determine how many headaches each subject presented, as well as the duration and intensity of the headaches. During the 10-week period where each subject received therapeutic massages, the reported frequency of headache episodes was reduced for every subject in the study. In each case, the reported duration of episodes was reduced as well[xi]. In all but one case, the test subjects reported that the intensity of their headaches was reduced; the lone subject who reported having a more intense headache still reported that the duration of that headache was significantly reduced, as was the frequency with which he go headaches[xii]. Along with these results, the most significant reported benefit among these subjects was that most saw a reduced frequency of their headaches for up to six months after treatment[xiii].

The protocol designed by the researchers in this study, having proven to be quite effective for the treatment of tension headaches[xiv], makes a solid basis for an overall treatment plan that a massage therapist could use for a client suffering from such headaches. While a massage therapist may certainly make suggestions about healthy eating and exercise to his or her clients, suggestions about diet and exercise, any such recommendations should be discussed with the client’s regular health-care provider. While each client’s needs will differ, the following regimen serves as a strong foundation on which therapist and client can build an effective treatment plan for combatting tension headaches:

(This regimen is performed with the subject in a supine position, face-down)

1. Tissue Warm-Up (5 minutes): moderate-pressure massage of the region stretching from the lower back to the neck, with long, slow strokes. This is intended to loosen muscles and increase blood flow to the region
2. Myofascial release (5 minutes): this will be focused on areas determined by patient and therapist in pre-massage consultation and during the actual massage. There are several techniques a therapist can use for myofascial release; each therapist should use his or her own discretion in choosing techniques
3. Axial Cervical Traction (2 minutes): the therapist gently supports the neck and forehead as gentle traction is applied; as the head is gently turned into different positions, the therapist holds each position for 15 seconds
4. Trigger-Point Therapy: a combination of pincer and palpation techniques are applied to appropriate areas, with pressure applied steadily until client reports that the area-specific pain is receding, or for 2 minutes, whichever is shorter
5. Facilitated Stretching: while this section of the treatment will be primarily focused on the head, neck, and shoulder regions, it may be helpful for the therapist to assist the patient in stretching the arms, legs, lower back, and other areas as well
6. Closure: gentle, long, slow strokes of the affected region and elsewhere to facilitate relaxation

The preceding regimen for treating tension headaches with massage therapy is just one way to organize and apply therapeutic massage techniques for such a purpose. Individual massage therapists are going to have their own preferred techniques and personal talents and abilities that may necessitate that the regimen be adapted accordingly. What the research has shown, however, is that regular treatments, with the consistent application of massage techniques, can be a highly effective means of treating tension headaches.

[i] Quinn, Christopher et al. “Massage Therapy and Frequency of Chronic Tension Headaches.” American Journal of Public Health. V92 N10. (2002). 1657-1661. Accessed online February 16, 2012.

[ii] Quinn,Christopher

[iii] Ibid.

[iv] Pace, Brian. “Tension Headache.” JAMA V285 N17. (2001). 2282. Accessed Online February 16, 2012

[v] McGeeney, Brian E. “Tension-type Headache.” Techniques in Regional Anesthesia and Pain

[vi] McGeeney, Brian E.

[vii] Pace, Brian

[viii] Pluta, Ryszard et al. “Tension-type Headache.” JAMA Online Article. Accessed online February 16, 2012.

[ix] Quinn, Christopher

[x] Ibid.

[xi] Ibid.

[xii] Ibid.

[xiii] Ibid.

[xiv] Ibid.

Bibliography

McGeeney, Brian E. “Tension-type Headache.” Techniques in Regional Anesthesia and Pain Management. V13 N1. (2009) 16-19. Accessed online February 16, 2012.

Menard, Martha Brown. “Headache relief: what massage therapy has to offer people who suffer from chronic tension headaches.” Massage Therapy Journal. V47 N4. (2008). 127. Accessed online February 16, 2012.

Pace, Brian. “Tension Headache.” JAMA V285 N17. (2001). 2282. Accessed Online February 16, 2012.

Pluta, Ryszard et al. “Tension-type Headache.” JAMA Online Article. Accessed online February 16, 2012.

Quinn, Christopher et al. “Massage Therapy and Frequency of Chronic Tension Headaches.” American Journalof Public Health. V92 N10. (2002). 1657-1661. Accessed online February 16, 2012.