Massage for Tension Headache and Migraine: What Is Known
What small trials and reviews found for massage in tension-type headache and migraine, why NCCIH calls the evidence too limited, and which headache signs need urgent care first.
Content last updated . This page has not been medically reviewed.
Urgent Signs First
Most headaches are not serious, but some are. The NHS (UK) says to call 999 or go to A&E (in the US, call 911) if a headache:- started suddenly and is extremely painful
- comes with weakness or numbness in the body or face, or trouble speaking, balancing, walking or remembering things
- follows a head injury in the last 3 months
- comes with a seizure, drowsiness or confusion, or loss of vision
- comes with a rash that does not fade when a glass is rolled over it, a very high temperature, a stiff neck, or bright lights bothering you
[1] It asks for an urgent appointment or NHS 111 advice for a headache with vision or eye problems, a headache triggered or worsened by coughing, sneezing, bending or exercise, a headache with vomiting, or a headache with jaw pain when eating or a sore scalp. [1] See a GP if you get headaches regularly or they are not getting better. [1]
Any of these means no massage until a clinician has checked you. Stroke signs after neck work are covered on neck massage and neck manipulation.
Two Headache Types, Briefly
Tension headaches cause pain on both sides of the head, face or neck, often felt as pressing or tightening, and last at least 30 minutes and sometimes days. [2] Common triggers include stress, sleep problems and caffeine. [2]Migraine causes a throbbing, often one-sided headache with nausea and sensitivity to light and sound. [3] The NHS says migraine cannot be cured, but treatment can help. [3] The NHS lists relaxation techniques and cognitive behavioral therapy among treatments to prevent attacks, and does not list massage. [3]
What the Summary Sources Say
NCCIH, the US government's complementary health agency, says that for massage, relaxation techniques, spinal manipulation and tai chi, the evidence on headache is too limited or inconsistent to reach conclusions. [4] Of massage specifically, it says limited evidence from two small studies suggests it is possibly helpful for migraine, but clear conclusions cannot be drawn. [4] That NCCIH page was last updated in August 2021.The NHS tension headache page lists massage among relaxing activities people can try, along with exercise and yoga. [2] That is a self-help suggestion, not a finding from a trial.
Tension-Type Headache: Trials and Reviews
A 2014 systematic review found only six trials of manual therapies for chronic tension-type headache; one applied massage and five applied physiotherapy. [5] Only two avoided other treatments running alongside, which can bias results. [5] The authors said the trials suggest massage and physiotherapy are effective options. [5] Weigh that against the small numbers and design problems.A placebo-controlled trial tested massage aimed at tender trigger points in neck muscles. Fifty-six people were randomized to 12 massage sessions, 12 sessions of a placebo (detuned ultrasound, which NCCIH calls an inactive treatment) or a waitlist. [6] [7] Headache frequency fell in both the massage and placebo groups, with no difference between them. [6] People did report a greater reduction in headache pain with massage than with placebo or waitlist, and pressure-pain thresholds improved only with massage. [6] The authors noted that tension-type headache, like other chronic conditions, responds to placebo and that trials without a placebo group risk overestimating the treatment's own effect. [6]
Migraine: Trials
A German trial randomized 64 people with migraine to lymphatic drainage massage, traditional massage or a waitlist, for 8 weeks. [8] By the end of the follow-up period, the number of migraine attacks had fallen by 1.8 with lymphatic drainage and 1.3 with traditional massage, versus 0.4 on the waitlist. [8] Because the comparison group waited without any treatment, the trial cannot rule out expectation or the effect of regular attention. A separate study adding hand massage to a behavioral program for migraine, in 83 people, found no effect on migraine frequency. [7]Evidence Summary
| Question | What the sources found | Strength of evidence |
|---|---|---|
| Massage for chronic tension-type headache | One massage trial in a six-trial review; placebo trial showed no frequency difference vs placebo [5] [6] | insufficient evidence |
| Massage for migraine prevention | One small waitlist trial positive; one hand-massage add-on trial null [8] [7] | insufficient evidence |
| Massage for relief during a migraine attack | We searched PubMed for massage with migraine and headache and found prevention trials only | Proper evidence not found |
Other Options With Their Own Evidence
For other approaches, see acupuncture for headache and migraine, acupressure for headache and pain, and pain and headache research. For general evidence on massage, see massage evidence by goal.Frequently asked questions
Does massage help tension headaches?
Evidence is limited. In a placebo-controlled trial, headache frequency fell with both massage and placebo, with no difference between them. [6]
Does massage prevent migraine?
NCCIH says clear conclusions cannot be drawn. [4] One small German trial found fewer migraine attacks with massage than waiting. [8]
When is a headache an emergency?
A sudden, extremely painful headache, or one with weakness, confusion, vision loss, seizure, head injury or a non-fading rash needs emergency care. [1] In the US, call 911.
Is scalp or neck massage safe with headaches?
Gentle massage appears to have few risks with a trained practitioner. [4] Forceful neck manipulation has been linked to stroke in case reports. [9]
Can I try massage with the headaches I get?
Ask a clinician first if the pattern is new or severe. [1] If it is ordinary tension, the NHS lists massage among relaxing activities. [2]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety and Who Should Check First
Head, neck and scalp work needs particular care. A new, sudden or different headache, or one with neck pain, can have causes other than muscle tension. Forceful manipulation of the neck has been tied to artery tears in case reports and observational studies, with uncertainty about cause. [9] We do not teach technique. Tell your therapist about migraine, blood thinners, clotting problems or recent head or neck injury. See massage safety.
If you use painkillers often, the NHS warns that taking them too much can itself cause headaches, and for migraine says to try not to take them more than 2 days a week. [2] [3] Talk to a pharmacist or doctor before changing any medicine. Massage is not a reason to stop or delay treatment.
References
- NHS, Headaches (UK; page last reviewed 17 April 2024). Read 2026-10-22.
- NHS, Tension headaches (UK; page last reviewed 1 August 2025). Read 2026-10-22.
- NHS, Migraine (UK; page last reviewed 10 March 2026). Read 2026-10-22.
- NCCIH, Headaches: What You Need To Know (page last updated August 2021). Read 2026-10-22.
- Chaibi A, Russell MB. Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials. The Journal of Headache and Pain 2014. PubMed abstract. Read 2026-10-22.
- Moraska AF et al. Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial. Clinical Journal of Pain 2015. PubMed abstract. Read 2026-10-22.
- NCCIH, Massage Therapy: What You Need To Know (page last updated May 2019). Read 2026-10-22.
- Happe S et al. The efficacy of lymphatic drainage and traditional massage in the prophylaxis of migraine: a randomized, controlled parallel group study. Neurological Sciences 2016. PubMed abstract. Read 2026-10-22.
- Biller J et al. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014. PubMed abstract. Read 2026-10-22.