Trigger Point Therapy - Treating Headaches (Part 1) 


TTH and trigger points

Muscular problems and tension are commonly associated with TTH, and trigger points within muscles may either be causative or may perpetuate TTH.

The most commonly affected muscles are trapezius, sternocleidomastoid, temporalis, masseter and occipitofrontalis. There is also a strong association with postural issues such as the upper crossed pattern.

Peripheral and Central Sensitization

The pain processing part of the central nervous system is almost certainly involved in TTH as it shows up abnormal in scans. Trigger points often add to the misery of headaches because they are associated with peripheral and central sensitization.

Long-term inputs from trigger points may lead to a vicious cycle that converts periodic headaches into chronic tension headaches. In such cases even if the original initiating factor is eliminated, the trigger point-central sensitization cycle can perpetuate or even worsen.

TTH's are often aggravated by stress, anxiety, depression, fatigue, noise, and glare, but they can also be associated with neck arthritis or a neck disc problem.

Acute or Chronic

TTH headaches can be episodic or chronic. Episodic tension-type headaches are defined as tension-type headaches occurring fewer than 15 days a month, whereas chronic tension headaches occur 15 days or more a month for at least 6 months. Headaches can last from minutes to days, months or even years, though a typical tension headache lasts 4–6 hours.

TTH fact file

1. The most prevalent form of benign primary headache with a reported prevalence varying from 65-90%, depending on the classifcation, description, and severity of headache features.

2. The psychosocial impacts of TTH include disruptions of daily activities, quality of life & work and are accompanied by considerable costs.

3. The International Headache Society (IHS) characterizes TTH as bilateral headaches of mild-to-moderate intensity that experienced with an aching, tightening, or pressing quality of pain.

4. TTH Headaches may last from 30 minutes to 7 days, are not accompanied by nausea or vomiting, and may have light sensitivity (photophobia) or sound sensitivity (phonophobia) but not both.

5. Headache frequency is classified as ‘episodic’ (<15 headaches per month) or ‘chronic’ (>15 per month).


See Treating Headaches - Part 2

See Treating Headaches - Part 3


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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 



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Scraping, a manual, ancient practice where pain points are worked with a gua sha (smooth-edged tool), reportedly increases blood flow by up to 400 per cent more than foam rolling and massage guns. By breaking up old, damaged blood vessels to promote new growth and healing, these tools are useful for getting into the nooks and crannies of a pain point, especially in delicate areas like along the shin muscles and under the foot.

Tim Tian has taken the scraper idea and supercharged it, creating a manual, triangular tool that blends heat and vibration therapy. “Cold blades stiffen muscles, blocking a deep release,” he says.

The heated scraper device takes just three seconds to reach 50ºC. This helps muscles soften, making it easier to massage away tension, increase blood flow and promote healing. The scraper is specially great for alleviating delayed onset muscle soreness (DOMS) in the quads, and provides a relaxing switch-up from the foam roller slog.