Tension Headaches (Myofascial Headaches): What Helps

Most people call it a tension headache: a dull, pressing headache that can feel like a tight band around the head, or that starts in the neck and shoulders and creeps up. We call it a myofascial headache, because that describes where it often comes from.

What a myofascial headache is

A myofascial headache is a headache that comes from, or is fed by, tight, tender spots in the muscles and fascia of your neck, shoulders, jaw and head. Those spots can send pain somewhere else, so a tight spot in your shoulder can be felt in your temple.

That's why rubbing your temple doesn't always help. The spot that hurts isn't always the spot that's feeding the pain.

What you can do

Massage the muscles, slowly. Work on your neck, shoulders and jaw. Press into the soft part of the muscle, not on bone.
Use a pressure that feels good. Never more than 7 on a scale from 0 to 10. If you hold your breath or tense up, it's too much.
Breathe out as you press. Many people hold their breath on a tender spot without noticing.
Notice the habits. Clenched teeth and shoulders up by the ears, at a screen or in the car, feed the same muscles.

Five points to try

These are the five points in our free routine. Spend about a minute on each, with steady, comfortable pressure.

Top of the shoulders (GB21)Halfway between the base of your neck and the tip of your shoulder, on the top of the muscle.
Base of the skull (GB20)In the soft hollows on each side of the back of your neck, just under the skull.
The jaw (ST6)About a finger's width up and in from the corner of your jaw, on the muscle that bulges when you clench.
The temples (Taiyang)In the small soft hollow just behind the outer end of your eyebrow.
The hand (LI4)On the back of your hand, in the fleshy web between thumb and index finger.

Pregnant?

Skip the top of the shoulder (GB21) and the hand point (LI4). Traditional advice is to avoid them during pregnancy.

When to see a doctor

See a doctor if you're unsure, and always if a headache is sudden, very intense and unlike anything you've had before. The same goes for a headache that keeps getting worse, or that comes with other symptoms. If you get migraines, go gently with the pressure, and stop if it seems to set off an attack.

Questions

Is a tension headache the same as a myofascial headache?

Not exactly. Tension headache is the name most people know. Myofascial describes where many of these headaches come from: tight, tender spots in muscles and fascia. The two often overlap, and they can overlap with migraine too.

How often should I do the routine?

Once a day for a week is a good start. Then notice: how often did the headache come, and how strong was it? The free PDF has a simple 7-day check for exactly that.

What if it hurts more?

Ease off. Tender is normal, sharp pain is not. If a point makes the headache worse, skip it.

Tension headaches (myofascial headaches)