Though we can be fairly certain that headaches do not come from birds using your hair to make a nest, as North Carolina folk wisdom would have us believe, it can sometimes be difficult to determine from where, exactly, that head pain does come. The location of your pain on your head, however, provides a lot of clues as to how to treat it. Sometimes a muscle or some other structure in the head can be the culprit, but it is just as likely that any of several neck muscles could be causing your head pain.
One of the muscles situated on the head itself, the aforementioned masseter muscle, may be the culprit if you feel pain in your sinuses, eyebrow, and ear, as well as your jaw. The masseter muscle can be stressed by, for instance, tension, grinding your teeth in your sleep, chewing gum, and crunching ice with your teeth. Treatment for this kind of headache could include applying sustained pressure to the tender spots in your jaw in attempt to get the tight spots there to loosen. Work that is myofascial (i.e., work on the fascia, or connective tissue, of the muscle) can also be helpful. Allow your finger or thumb to sink into the muscle just below the cheekbone and slide very slowly to the jaw.
Of course, pain in your sinuses can also be a sinus headache! One way to determine the difference is if bending makes the pain feel worse, it is likely the sinuses. Acupressure points can be very effective in treating sinus issues.
Another muscles situated on the head that may be painful in and of itself is the temporalis muscle, which stretches from the joint in your jaw across part of your skull above your ear. Tightness in temporalis can cause pain in a tooth, along the eyebrow, behind your eye, and on the side of your head. Many of masseter’s stressors also affect temporalis. Rubbing across the several fiber directions of this muscle can help loosen it.
If you feel pain that penetrates inside the skull and seems to be all over, four little muscles at the base of your skull might be the cause. The suboccipitals can become stressed if you have been gazing upward for an extended period of time, with your head titled back, for instance, or if you’ve been doing a lot of typing while reading copy from a flat surface.
Pain directly on top of your head—sometimes known as a dome headache—could be caused by a muscle in your neck that crosses from below your ear to the vertebrae of lower neck and upper back. Splenius capitis can be strained as a result of cold air blowing on the neck, whiplash, or painting a ceiling.
A headache that spreads from the scalp to the eye region might be the result of tightness in semispinalis capitis, which goes from the base of the head to vertebrae in the neck and upper back. Sustained flexion of the neck, how you sleep, improper adjustment of eyeglasses, and lack of lumbar support when sitting can all be contributing factors. Active assisted stretching and hydrotherapy can be excellent ways to treat this type of pain.
Finally, the muscle that stretches from your collarbone and top of your sternum to just under the ear generally sends pain to the forehead, around the eyes, to the back and the top of the head, and to the cheek. This pattern mimics the classic migraine arc. (Migraine headaches, by the way, are not muscular in nature but, instead [according to the National Institutes of Health], changes in nerve pathways and chemicals in the brain.) The sternocleidomastoid, or SCM, can be adversely affected by lying on your side while reading, prolonged driving, collars or neckties that are too tights, and drooping shoulders. Pincer compression and stretching are both helpful in alleviating SCM pain.
Not all headache pain can or should be treated by a massage therapist, of course. Any of the following accompanying signs or symptoms should have you considering consulting a physician: vomiting with no nausea, visual disturbance, a headache that starts when you’re lying down, especially if it wakens you from sleep, a headache that pulses synchronously with your heartbeat, headaches that get worse when you’re active, numbness, altered sense of taste, smell, or hearing, or loss of coordination.
But if your headache is free from such additional symptoms, tell me where it hurts, and I’ll help relieve the pain—whether it originates in your head or somewhere else.