Treating Headaches and Neck Pain

December 15, 2010

One of the most common complaints clients have today are headaches and neck pain. Headaches and neck pain are common and caused by many factors including stress, chemical imbalances, breathing disorders, side effects from medication, sinus disorders, nerve impingement and many more internal and external factors.  

The two most common types of headaches include:

• Vascular – Vascular type headaches include migraines and cluster headaches
• Tension – Tension type headaches account for approximately 75% of all headaches sufferers  

Neck pain is most commonly caused by:

• Repetitive strain
• Postural dysfunction  

Neck pain is usually either soft tissue or nerve orientated and may or may not occur in conjunction with headaches. As a massage therapist and body worker it is your job to assess client headaches and neck pain in order to find the best possible treatment options. When in doubt, always refer your client to another healthcare provider for an accurate diagnosis before treatment.  

When assessing headache and neck pain, it is first important to ask the client what type of pain they are experiencing. Is the pain sharp, shooting or dull and aching? It is also important to obtain an informed consent and complete medical history. The medical history will help you determine if massage is indicated or contraindicated for the client’s current symptoms. Once you have determined that massage is ok, you may proceed with your assessment. If you are unsure if massage is ok, refer your client to another healthcare provider. Assessment includes determining the type of pain and/or injury and the possible areas of restriction.

• The following is a generalized list of symptoms and possible causes for pain:
• Cramping, dull, aching pain may indicate muscle injury
• Sharp, shooting, or lightening-like pain may indicate that a nerve or nerve root is injured
• Burning, stinging pressure may indicate sympathetic nerve injury
• Deep, nagging pain may be due to a bone injury
• Throbbing, diffuse pain may indicate injury to a blood vessel  

Other assessment procedures include:

• Pain rating scales
• Pain questionnaires
• Palpation assessment
• Muscle testing
• Neuromuscular technique  

Once you have assessed your client’s current symptoms you can begin treatment. Choosing the best type of treatment or massage modality to use will be dependent on several factors:

• Your knowledge and experience
• The client’s pain level
• Your and the client’s treatment goals for the session  

There are many massage modalities you can use to treat headaches and neck pain. A few are listed below:

• Swedish massage – Swedish techniques will relax and calm your client
• Connective tissue massage/myofascial release – Focusing on releasing restricted fascia may be helpful in rebalancing posture and relieving pain
• Neuromuscular technique – NMT focuses on assessing and releasing taught bands of tissue and trigger points which is helpful in the treatment of pain
• Trigger point release – Headaches and neck pain may be caused by myofascial trigger points in the muscles. Assessing for and relieving trigger points may be beneficial in treatment.
• Muscle energy techniques/positional release techniques – Muscle energy techniques and positional release techniques such as reciprocal inhibition and strain-counterstrain use stretching and movement to release dysfunction in tissues
• Deep tissue massage – Depending on your client’s pain level, deep work on the neck and head can be very effective in relieving symptoms and correcting imbalances  

A comprehensive approach in addressing headaches and neck pain using several different massage and medical modalities is a valuable treatment strategy. Complimentary methods to massage therapy which also may be beneficial include:

• Physical therapy
• Chiropractic
• Occupational therapy
• Muscle strengthening
• Psychotherapy
• Exercises  

It is also important to keep in mind that you will not cure a headache or neck pain in one treatment. For massage to be effective, clients should be recommended a treatment protocol including weekly sessions for at least 4-6 weeks. Followed by a re-evaluation and further recommendation.  

We have a course available titled Massage for Headaches and Neck Pain, 9 CE hours. This course outlines all of the above and gives much more information on how you can best treat your clients. Course cost is $104.00 and includes a textbook, DVD and multiple choice exam. Click here to view the full details.  

Source: A Massage Therapists Guide to Treating Headaches and Neck Pain, by Sandy Fritz and Leon Chaitow