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University of Colorado College of Nursing

College of Nursing

Headache hassles: Can massage therapy reduce the frequency of tension headaches?

Massage Study

​For Assistant Professor Albert Moraska, PhD, a teaching opportunity at Boulder College Massage Therapy during graduate school at the University of Colorado Boulder in the early 1990s led to his interest in the nexus between Western and Eastern medicine. He has been pursuing that research interest ever since.

“It was kind of serendipitous—a poor graduate student at the time who needed some income, but it actually turned into being very rewarding, and it was an area that needed some research. I was intrigued by its [massage] effects.”

Dr. Moraska is now conducting a three-year study funded by the National Institutes of Health that asks the question: Will a reduction in myofascial trigger point pain result in a reduction in tension headache pain? Myofascial trigger points refer to nodules within muscles that are tender or painful, Moraska explains, and that may or may not be the original source of pain.

“Within many skeletal muscles are these tightly contracted muscle nodules. So, it’s not the full muscle that’s being contracted, but just a small portion of the muscle and these areas are sites of local pain. They hurt wherever that spot is but they also produce what is called referred pain,” he says. For instance, pain in the shoulder can produce pain that is sensed in the head. Consequently, a “tension headache is actually a symptom of pain rather than the primary cause. The primary cause of tension headaches, we believe, is the trigger points, and we think massage is an effective treatment at these trigger points.”

The 14-week study has 60 participants, 18-60 years of age, diagnosed with tension headaches for at least six months and largely recruited from the Pain Medicine Clinic at the University of Colorado Hospital. All participants are asked to keep a headache diary and are randomized into three groups: massage therapy group, placebo group and a control group. After being split up into groups, researchers assess the trigger points by using a pressure algometer—an instrument which measures how tender the spot is on the body. Then, both the massage group and the placebo group receive weekly treatments. While the massage group receives massage, the placebo group receives ultrasound treatments that mimic the massage in terms of treatment environment, time and contact with professional therapists.

The study is looking at two measures: how painful the trigger points are (measured by the algometer instrument) and the decline in frequency of tension headaches for the participants (measured by the participants’ headache diaries). Although the frequency of tension headaches are decreasing in both the massage and the placebo groups, researchers are seeing “very impressive changes in pain sensitivity with those that received the massage and no changes with those that received the placebo treatment or those in the control group,” Moraska explains. In other words, massage helps trigger points become less painful, which could be beneficial for treating other types of myofascial pain, such as low back pain or whiplash associated disorder.

Much has been written about tension headaches in academic journals. However, the literature typically focuses on pharmaceutical treatments. What makes Dr. Moraska’s study unique is that he combines Eastern medical techniques with accepted Western medicine measurement techniques in researching how to reduce headache pain.

“Hopefully, under ideal circumstances, we’ll find that complementary medicine is a viable treatment alternative for those who wish to pursue it for tension headache relief.”