If you get migraines, you have probably already been told to track your triggers, drink more water, sleep better, and manage your stress. Useful advice, as far as it goes, and frustrating when you are doing all of it and still losing days.
What gets discussed less is the neck.
Not every headache is the same thing
Headaches get lumped together, but they behave differently. Tension headaches tend to be a band of pressure. Migraines often come with light sensitivity, nausea, and a throbbing quality on one side. And there is a third category, cervicogenic headaches, which originate in the neck and refer pain up into the head.
That third kind is frequently mistaken for migraine, because the pain lands in the same place. The difference is the source.
Plenty of people have more than one kind. It is entirely possible to have genuine migraines and also have a neck that is generating additional headaches on top of them.
What the neck contributes
A small group of muscles at the base of the skull, the suboccipitals, attach the head to the top of the spine. They are dense with nerve endings and they sit directly next to the nerves that supply sensation to the scalp.
When those muscles stay contracted, they can refer pain in a pattern most headache sufferers recognise immediately: starting at the back of the head, wrapping over the top, settling behind one eye.
The upper trapezius and the muscles along the side of the neck contribute their own referral patterns, into the temple and behind the ear.
Where massage fits
Massage is not a cure for migraine, and anyone telling you otherwise is overselling. Migraine is a neurological condition with a lot of moving parts.
What hands-on work can do is reduce the muscular contribution. For some people that is a small slice of the problem. For others it is a surprisingly large one, and reducing it means fewer headaches, shorter ones, or ones that respond better to their usual medication.
The realistic goal is frequency and severity, not elimination. People who get the most out of it tend to come consistently for a while rather than only when a headache has already arrived, because treating during an active migraine is often too much stimulus.
What a session involves
Focused work through the suboccipitals, the cervical muscles along the neck, the upper trapezius, and often the jaw, since jaw tension and head pain travel together more often than not.
It is slow work. The suboccipitals are small and deep, and they do not respond to force. They respond to sustained, patient pressure and to the nervous system deciding it is safe to let go.
Worth saying plainly
Sudden, severe headache unlike anything you have had before, headache following a head injury, or headache with fever, confusion, vision loss, or weakness needs medical attention, not massage. Those are not the ones we are talking about here.
For the long-running, familiar, grinding kind that has become part of your month, it is worth finding out how much of it is coming from your neck. For a lot of people it is more than they expected.