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Tension headaches — neck and shoulder tension

When a headache starts in the neck — and what you can do about it.

7 min read

If your headache starts at the back of the neck, radiates to the temples or the back of the head, and gets worse when you work at a desk — it's probably a myofascial tension headache. It originates in tight neck and shoulder muscles, known as trigger points. It's worth knowing that this can be addressed effectively — without reaching for medication straight away.

What is a tension headache?

  • Pressing pain — felt like a "band" or "helmet" around the head
  • Usually bilateral, though it can start on one side, from the neck
  • Mild to moderate intensity
  • Gets worse with sitting, computer work and stress
  • Often eases after muscle relaxation, a warm shower or massage

Trigger points — what they are and which muscles matter most

Trigger points are areas of overly tense muscle fibres. A key feature: pressure on them often triggers pain elsewhere in the body — for example, pressing the trapezius can cause pain in the temples.

  • Trapezius — neck and shoulders
  • Sternocleidomastoid (SCM) — side of the neck
  • Suboccipital muscles — where the neck meets the head
  • Masseter — jaw and temples (often linked to bruxism)

Neck and shoulder massage with trigger point release

A massage focused on releasing trigger points combines several techniques: ischemic compression (point pressure), MET (muscle energy technique) and deep tissue massage. This approach reaches the source of tension directly, rather than just easing its effects.

Cupping therapy — releasing fascia

Dynamic cupping massage over the trapezius releases fascia and improves microcirculation in tense areas. It's often used alongside classic massage — cupping reaches layers that manual kneading alone struggles to access.

Kinesiotaping — support between sessions

Applying kinesio-tape to the trapezius and neck gives gentle proprioceptive support and relieves the muscle. Kinesiotaping works between massage sessions — it extends the treatment's effect and can reduce recurring tension.

Botox in the trapezius — for chronic pain

For chronic tension headaches, an injection of botulinum toxin into the trapezius can give a relaxing effect that lasts several months. This is an option for people who get headaches very often, alongside bruxism or the characteristic stress-related "shoulders up by the ears".

Bruxism as a possible cause of headaches

If the pain appears in the morning after waking, or after long conversations and meals, it's worth considering bruxism (night-time teeth clenching or grinding) as an additional source of tension. In this case, a dental consultation helps — and in selected cases, a Botox injection into the masseter.

When you must see a doctor