If you suffer from regular headaches, your neck might be playing a bigger role than you think.
Tension-type headaches are the most common form of headache, accounting for up to 70–90% of all headaches in the general population. They are often described as a dull, aching pain or a feeling of tightness around the head—and are closely linked to muscle tension and stress.
So what’s actually happening?
The muscles of the neck and upper shoulders—particularly the upper trapezius, suboccipitals, and levator scapulae—can become overactive due to prolonged posture (like desk work), stress, or fatigue. Research shows that increased muscle tenderness and sensitivity in these areas is strongly associated with tension-type headaches.
There’s also a neurological component.
The upper cervical spine (neck) shares nerve pathways with areas of the head through what’s known as the trigeminocervical nucleus. This means that irritation or tension in the neck can “refer” pain into the head—one of the reasons neck dysfunction is so commonly linked to headaches.
Stress plays a significant role too.
Psychological stress has been shown to increase muscle tension and pain sensitivity, contributing to both the onset and persistence of headaches. This helps explain why headaches often appear during busy or emotionally demanding periods.
And yes—women are more likely to experience tension-type headaches than men, likely due to a combination of hormonal, physiological, and psychosocial factors.
So how can massage help?
Massage therapy can be an effective part of managing both the physical and physiological contributors to headaches.
Evidence suggests massage can:
• Reduce muscle tension and tenderness in the neck and shoulders
• Improve blood flow and tissue mobility
• Decrease stress hormones and promote relaxation
• Reduce the frequency and intensity of tension-type headaches in some individuals
By addressing both muscular tightness and the nervous system, massage supports a more holistic approach to headache management.
What makes treatment effective?
1. Individualised care
There is no one-size-fits-all approach. Effective treatment should consider your specific triggers, posture, lifestyle, and pain sensitivity. The pressure, technique, and areas treated should all be tailored to you.
2. Consistency matters
One-off treatments can provide short-term relief, but ongoing care is often needed to create lasting change. Regular treatment can help manage muscle tension before it escalates into a headache.
3. A proactive approach
Many people wait until their pain is severe before seeking help. However, research supports a more preventative approach—managing muscle tension and stress early can reduce the frequency and severity of headaches over time.
Headaches are rarely “just in your head.”
By understanding the connection between neck tension, posture, and stress, you can take a more informed and proactive approach to managing them—supporting not just symptom relief, but long-term wellbeing.
* peer reviewed Loder E, Rizzoli P. Tension-type headache. BMJ. 2008;336:88–92.
** ref world health organisation https://www.who.int/news-room/fact-sheets/detail/headache-disorders