The bigger the headache, the bigger the pill?

With Tim Wright - Gower Acupuncture (Swansea)

Well not so in the case of many tension type headaches

The common component of many tension headaches is, not surprisingly perhaps, muscular tension. If your headache gets worse after maintaining a poor posture (working at your computer), varies in intensity with stretching or exercise or changes with movement, then you may have a headache with muscular tension at its root. The muscles most likely to be causing your headache are listed below. Have a careful prod around. If you get pain or sensitivity when pushing on any of the muscles below you may have found the culprit.

Human head and neck anatomy illustration

1.Sternocleidomastoid. This is a long muscle running diagonally down the neck, crossing from behind the ear at the base of the skull diagonally forward to almost central on the clavicle (collar bone). Take a look in the mirror – rotate your head to the left (as if reversing in the car). Your right Sternocleidomastoid will become more prominent. Whilst it may be fairly easy to locate, it’s not the easiest to feel. Don’t push too deep because there are numerous delicate structures in close proximity – carotid artery, jugular vein, vagus nerve and lymph nodes. Pain can be felt over the front of the head. Due to its function of keeping the head level it can be responsible for a dizzying array of symptoms – literally – including dizziness, tinnitus, stuffiness in the ear and feelings of nausea.

2. Temporalis. Imagine a big circle, diameter a couple of inches, situated further back on the head between (and slightly higher than) your eye and ear. This is the temporalis. It’s a big flat muscle responsible for chewing motion of jaw. If you chew gum or grind your teeth deactivating this may help your headache. This is a tricky one to feel for as the muscle is so thin. It needs to be as it’s on the side of your head. Anyway, clamp your jaw down and try to feel for the muscle. If you feel pain around this area and down into the jaw area and over the eyebrow you have found part of your problem.

3. Upper Trapezius. This is the triangle that bridges from your neck down to your shoulders. It’s an important muscle for maintaining an erect posture. It helps to raise the shoulders when shrugging, laterally flex the neck (put ear onto the shoulder) and extends the neck (as in looking up). Pinch across the sloping ridge from neck to shoulder. This is tender on a lot of people. Upper trapezius headaches typically refer pain onto the eyebrow area on the front of the head. This is a muscle that’s easy to feel for and easy to self-massage.

4. Sub Occipitals. These muscles sit under the occiput (base of the skull at the back of the head). They are a group of muscles primarily responsible for rotating (turning) and extending (looking up into the sky) the head. Pain from these muscles typically refers pain forward between the level of the upper part of the ear and the eye in a band round the head. Reach back and have a feel under the skull at the back of the head. Be aware though that the back of the head is a congested area full of many other muscle insertions that could be causing a very different type of headache.

5. Superior Oblique. This muscle sits behind the eye and is responsible for moving the eye. Look up and to the outside of your head and you’ll be stretching this muscle. If doing this replicates your headache, it’s likely you’ll need to start being a bit kinder to your eyes. Pain from this muscle tends to be felt deep behind the eye.

So we’ve briefly looked at a few muscles that can be responsible for tension type headache. This is by no means an exhaustive list and also bear in mind that these muscles rarely work in isolation. Dysfunction in one muscle can affect other nearby muscles causing a propagation of pain.

Although muscular tension is often a prominent component of headaches there are a plethora of other avenues to investigate; neurological (nerve entrapment, brain injury), vascular (poor blood supply, vasodilation, vasoconstriction), poor breathing patterns, chemical irritants (such as sensitivities to food, pollen, cleaning products), nutritional deficiencies, insomnia… and so the list goes on. If you’d like to read more about headaches and potential causes go to

To contact Tim: email: mobile: 07764 254881




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