How I Approach a Massage Session When You Have Headaches and Neck Tension

Headaches and neck tension often show up in unison with each other, however, that does not mean every person experiencing them needs the same type of massage. Some people can have the same exact conditions, diagnosis, surgeries, and still not have the same approach to massage. Some people will tell me how their neck feels tight after spending the day at a desk. Others notice tension around their shoulders and upper back. Some experience recurring headaches and are looking for supportive care as part of their overall wellness routine. My first step is not to assume I know what is causing the problem, but to start learning more about what that individuals body is experiencing. From there, what they hope to accomplish from the session becomes a clearer road map.

I Start With the Person, Not Just the Headache

When someone comes in with headaches or significant neck tension, I want to understand more than where they hurt.

I may ask about:

• Where they typically feel the headache
• How often the headaches occur
• Whether anything seems to trigger or worsen their symptoms
• Whether they experience neck, jaw, shoulder, or upper back tension
• What activities seem to affect their symptoms
• What they have already tried
• Whether they have discussed recurring headaches with a healthcare professional
• What they hope to get from the massage session

These questions help me understand the person’s goals and determine how to approach the session within the scope of massage therapy.

Jessica’s Perspective

One of the first things I want to understand is what a typical day looks like for that person in particular and when they tend to notice the tension building.

Does it wrap around to the jaw, base of skull, or behind their eyes?

Sometimes, the change in weather can have a significant impact on headaches.

Headaches Are Not All the Same

This is one reason I avoid assuming that every headache should be approached the same way. A person experiencing occasional tension associated with a stressful week may have a very different experience from someone who has recurring migraines or a new pattern of headaches. While Massage therapists do not diagnose headache disorders, my role is to stay within the scope of massage therapy, listen to what the person is experiencing, and determine whether massage is appropriate for their care plan. For those who have recurring headaches, I also want to know whether they have already been evaluated and whether they have any guidance or restrictions from their healthcare provider.

Neck Tension Can Be Part of the Conversation

Many people who come in for headaches also describe tension around the neck, shoulders, jaw, or upper back. That information matters. However, I do not automatically assume that tension in one area is the cause of a person’s headaches. Instead, I look at the person’s experience as a whole.

What activities seem to increase tension?

Do they spend long periods at a desk?

Do they notice jaw tension?

For women, does it come and go with their cycles?

Do they feel discomfort after certain activities?

What areas feel restricted or uncomfortable?

How does the person describe their symptoms?

The answers help shape the massage session.

Every Session Is Individualized

I do not believe in using the exact same routine for everyone who comes in with neck tension or headaches.

Pressure preferences are different.

Areas of discomfort are different.

Goals are different.

Some people want focused therapeutic work on areas that feel consistently tight. Others want a broader massage session that addresses multiple areas contributing to their overall feeling of tension. Some people exclusively want their problem areas worked and knocked out before moving to the rest of the body. Communication throughout the appointment matters.

If pressure is too much, I want to know.

If an area feels unusually sensitive, I want to know.

If something changes during the session, I want the person to tell me.

Massage should not be something someone merely endures.

What I Want People to Tell Me Before Their Session

You do not need to arrive with a diagnosis or a perfect explanation. It is helpful to tell me:

• How long you have been experiencing the problem
• Whether your symptoms are new or recurring
• Where you feel tension or discomfort
• What seems to make your symptoms better or worse
• Whether you experience other symptoms along with your headaches
• What you have already tried
• What you hope to accomplish from the session

That information gives us a better starting point for discussing whether massage is appropriate and how I can tailor the session to your goals.

When Massage Should Not Be the First Step

New, severe, unusual, or rapidly worsening headaches should not simply be treated as ordinary tension. The National Institute of Neurological Disorders and Stroke provides information about headaches and migraine disorders, including the importance of medical evaluation for concerning symptoms.

If you experience a sudden, severe headache or a significant change in your usual headache pattern, seek appropriate medical guidance.

Other symptoms that may warrant medical evaluation include neurological changes, confusion, weakness, changes in vision, or other concerning symptoms.

Massage therapy can be part of a person’s wellness or supportive care plan, but it is not a replacement for medical diagnosis or emergency care.

What I Want the person to Get From the Session

My goal is not to promise that massage will eliminate someone’s headaches. My approach is to understand what the person is experiencing and provide an individualized massage session within my scope of practice. Now, lets say someone dealing with persistent tension, that may mean focused work based on their preferences and goals. For another session, it may mean a broader session focused on overall muscular tension and relaxation. For someone whose symptoms suggest they should seek medical evaluation first, the right answer may be not to proceed as though massage is the only solution. That professional judgment matters across all industries.

My Approach at Inspire Movements

At Inspire Movements Massage Therapy, I believe the conversation before and during a session is just as important as selecting a technique. I want to know what you are experiencing, understand what you hope to achieve, and I will always want your feedback throughout the session. Most importantly, I do not want to treat you as though your experience is identical to the person who was on my table before you.

If you are in Colorado Springs and dealing with neck tension or recurring headaches, you can learn more about my approach to headaches and migraines or contact me before booking if you have questions about whether massage is appropriate for your situation.

About Jessica Deardorff, LMT

Jessica Deardorff is the owner of Inspire Movements Massage Therapy in Colorado Springs and has been practicing massage therapy since 2016.

Her areas of focus include low-back pain, sciatica support, headaches and migraines, mobility-focused massage, therapeutic Ashiatsu, and cupping.

Jessica’s approach centers on individualized massage therapy, clear communication, and understanding the goals rather than using the same routine for every person.

Learn more about Jessica’s training, credentials, and approach.

Sources and Further Reading

National Institute of Neurological Disorders and Stroke – Headache information

MedlinePlus – Headache information

Educational disclaimer: This article provides general educational information and does not diagnose headaches or other medical conditions. Massage therapy may not be appropriate for every situation. Seek appropriate medical evaluation for new, severe, unusual, or worsening symptoms.