The Evidence: Massage Therapy for Tension Headaches and Migraine
Headaches are among the most common neurological conditions worldwide. Tension-type headaches and migraines can significantly affect work, family life, sleep, concentration, and overall quality of life. While medications remain an important part of treatment for many people, growing research supports massage therapy as a complementary, non-pharmacological approach that may help reduce headache frequency, pain intensity, muscle tension, and disability (Wells et al., 2019; Bashir et al., 2022).
Massage does not cure migraines or headaches, but evidence suggests it can help address many of the physical and neurological factors that contribute to recurring headache pain.
What the research shows…
1) Massage may reduce headache frequency and intensity
Several systematic reviews and clinical studies have found that massage therapy can reduce both the frequency and severity of headaches, particularly tension-type headaches and migraines (Wells et al., 2019; Bashir et al., 2022).
Reported outcomes include:
- Fewer headache days
- Reduced pain intensity
- Shorter headache duration
- Less reliance on pain medication
- Improved quality of life
Manual therapies are increasingly recognized as part of a comprehensive headache management plan, particularly when headaches are associated with muscle tension, stress, or neck dysfunction (Wells et al., 2019).
2) Massage may reduce muscle tension that contributes to headaches
Many tension headaches and migraines involve increased muscle tension in the neck, shoulders, jaw, scalp, and upper back. Tight muscles and myofascial trigger points can contribute to pain referral patterns and increased sensitivity.
Massage therapy may help:
- Reduce muscle tension
- Decrease myofascial trigger point activity
- Improve tissue mobility
- Reduce jaw and neck tightness
- Improve cervical mobility
A case series investigating chronic tension-type headaches found greater improvements when treatment included the sternocleidomastoid, scalene, temporalis, and masseter muscles in addition to the neck and upper back. Participants experienced meaningful reductions in headache frequency and headache-related disability (Shields & Smith, 2020).
3) Massage helps calm the nervous system
Migraine is now understood as a complex neurological condition involving heightened nervous system sensitivity. Stress, poor sleep, anxiety, muscle tension, and sensory overload can all contribute to triggering migraine attacks.
Massage may help regulate the autonomic nervous system by:
- Increasing parasympathetic (“rest and restore”) activity
- Reducing stress-related muscle guarding
- Lowering physiological arousal
- Promoting deep relaxation
- Supporting better sleep
By calming the nervous system, massage may reduce some of the factors that contribute to headache recurrence (Spinu et al., 2020; Wells et al., 2019).
4) Massage may improve neck pain and mobility
Neck pain is one of the most common symptoms associated with migraines. Approximately 75% of people living with migraine also report neck pain before, during, or after an attack (Bulut & Özdemir, 2025).
Research suggests massage therapy may help:
- Improve cervical range of motion
- Reduce neck stiffness
- Improve posture-related muscle tension
- Reduce headache-related disability
- Improve daily comfort
A case report involving a person with migraines and cervical spondylosis found improvements in cervical range of motion, reduced neck stiffness, fewer migraines, and improved sleep following a series of massage therapy treatments (Rostron, 2021).
5) Massage may improve quality of life
Migraines affect far more than pain alone. They often interfere with work, exercise, relationships, concentration, and emotional well-being.
Research has found massage therapy may contribute to:
- Improved daily functioning
- Reduced headache-related disability
- Better quality of life
- Improved emotional well-being
- Reduced stress
A 2024 randomized controlled trial found that aromatherapy massage, when provided alongside standard medical care during migraine treatment, significantly improved pain severity and migraine-related quality of life compared with medical treatment alone (Akyüz et al., 2024).
6) Massage works best as part of a comprehensive headache management plan
Headaches and migraines are influenced by many factors, including sleep, stress, posture, hormones, physical activity, nutrition, and nervous system sensitivity.
Current evidence supports massage therapy as one part of a multidisciplinary approach that may also include:
- Medical management
- Exercise therapy
- Physiotherapy
- Stress management
- Sleep optimization
- Trigger identification
- Relaxation training
Massage provides a low-risk, non-invasive option that can complement medical care and support long-term headache management rather than replace it (Bashir et al., 2022).
What this means in practice
Massage therapy does not cure headaches or migraines. However, research suggests it can help reduce muscle tension, calm the nervous system, improve neck mobility, and decrease headache frequency and disability for many people.
People often report:
- Fewer headaches
- Reduced migraine intensity
- Less neck and shoulder tension
- Better sleep
- Improved movement
- Reduced stress
- Better quality of life
By addressing both the physical and neurological contributors to headache disorders, massage therapy can become an important part of a comprehensive, evidence-informed approach to managing headaches and migraines.
References
Akyüz, H. Ö., Şenturan, L., & Sabuncu, N. (2024). The effect of aromatherapy massage on the pain severity and quality of life in acute migraine attacks: A randomized controlled trial. Florence Nightingale Journal of Nursing, 32(2), 159–167.
Bashir, N. M., Meeus, M., Gürşen, C., Mohammed, J., De Pauw, R., & Cagnie, B. (2022). Effectiveness of hands-off therapy in the management of primary headache: A systematic review and meta-analysis. Evaluation & the Health Professions, 45(2), 183–203.
Bulut, B. Y., & Özdemir, Ö. Ç. (2025). Comparison of the efficacy of connective tissue massage and manual lymphatic drainage in patients with migraine: A randomized controlled trial. Journal of Oral & Facial Pain and Headache, 39(3), 121–132.
Rostron, S. (2021). The effects of massage therapy on a patient with migraines and cervical spondylosis: A case report. International Journal of Therapeutic Massage & Bodywork, 14(3), 15–21.
Shields, G., & Smith, J. M. (2020). Remedial massage therapy interventions including and excluding sternocleidomastoid, scalene, temporalis, and masseter muscles for chronic tension-type headaches: A case series. International Journal of Therapeutic Massage & Bodywork, 13(1), 22–31.
Spinu, A., Andone, I., Popescu, C., Sporici, A., Mandu, M., & Onose, G. (2020). Recent updates on massage therapy in clinical care. Romanian Journal of Medical Practice.
Wells, R. E., Beuthin, J., & Granetzke, L. (2019). Complementary and integrative medicine for episodic migraine: An update of evidence from the last three years. Current Pain and Headache Reports, 23(2), 10.