Osteopathy and Trigger Point Headaches

Trigger Point Headaches
Anjy Chahal, Registered Osteopath, Ealing

Anjy Chahal’s research into Trigger Point Headaches continues to inform her practice in this area.  Her insights are shared in the post below.


Tension Headaches

Tension headache is the most common type of headache and is usually described as a pain that feels like a tight band round the head, or a weight on top of the head. Sufferers may also feel pain along the neck and shoulders which can last from 30 minutes to several days, or may re occur depending on the severity. The most common causes of tension headaches are muscular tension, associated postural fatigue and stress.


A migraine is usually a severe headache felt as a throbbing pain on one side of the head, with other symptoms such as visual aura and nausea. Migraine tends to cause more disability than tension headaches. 1 in 10 people suffer from migraine headaches and associated symptoms. Migraine attacks can vary in occurrence and intensity, they can last from 4 up to 72 hours depending on the individual.

What are Trigger Points? 

The term trigger point refers to a sensitive area in a muscle or fascia that becomes painful when direct pressure is placed upon it. This direct compression can cause local and referred pain. For example, when the muscle at the top of your shoulder has a trigger point it will refer pain up the side of your head and neck which can cause headaches or amplify an existing headache – as in a Migraine attack.

Trigger points are classified as either active or latent; an active trigger point is always tender and causes a clinical complaint, it initiates a local twitch response of the muscle fibres when stimulated with compression and prevents full lengthening of the muscle. Latent trigger points are pain-free  neuromuscular lesions that are usually associated with muscle overuse.

Trigger Point Headaches 

Trigger Point Headaches may be involved in both tension headaches and migraine. The mechanism is as follows.

Trigger points in the muscles at the base of the skull (suboccipital muscle group) are the most common cause of tension headaches. The suboccipital group work to keep your head balanced on top of your spine. Due to the constant use of this area, the muscles surrounding the head and neck overwork which then lead to the build up of muscular knots.  Trigger points are usually a common feature in tension headaches.

When trigger points refer pain they can trigger a  migraine attack in a person who has a history of Migraine headaches. Research shows that the longer the history of migraines, the more trigger points occur in the muscles and therefore the more frequent the attacks.

How can Osteopathy help Trigger Point Headaches? 

Osteopathy can help by using various techniques  such as mobilisation, stretching and trigger point release therapy in order to help relieve the muscles and surrounding tissues.

Trigger point release focuses on releasing the muscular tightness and shortening of the muscles via cycles of isolated pressure and release. Dry needle treatment (also known as medical acupuncture) can also be used to release trigger points.  This intermittent pressure encourages the muscle fibers to release these trigger points by calming neuromuscular over stimulation.

Osteopathy treatment can almost always alleviate tension headaches.  In Migraine, osteopathy may help to reduce the severity of attacks where trigger points are a feature of those headaches.