Trigger Point Therapy for Migraines
Knot Your Ordinary Massage

Written and verified by Holly Hazen

One in ten people suffer from migraine headaches. Trigger point therapy is becoming well known as an effective approach you can use yourself, as in self care, or from a trained practitioner to get some quick relief from your aggravating headache or muscle pain.

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It focuses on releasing the fascia connective tissue in the body which is why it is often referred to as myofascial release or myofascial trigger point massage.

According to dictionary.com the word my•o•fas•ci•al (mī'ō-fāsh'ē-əl) adj. means "of or relating to the fascia surrounding and separating muscle tissue.”

More specifically, fascia is “a sheet or broad band of fibrous connective tissue that is deep to the skin and surrounds muscles and other organs of the body” (Tortora and Grabowski, 2000, p. 271). The superficial fascia separates muscle from skin and protects muscle tissue.

”It is composed of areolar connective tissue and adipose tissue and provides a pathway for nerves and blood vessels to enter and exit muscles. The adipose tissue of superficial fascia stores most of the body’s triglycerides, serves as an insulating layer that reduces heat loss, and protects muscles from physical trauma."

"Deep fascia is dense, irregular connective tissue that lines the body wall and limbs and holds muscles with similar functions together. Deep fascia allows free movement of muscles, carries nerves and blood lymphatic vessels, and fill spaces between muscles” (ibid.).

If none of that made sense, just know it's important stuff in the body. It kind of holds you all together.

I have tried both the massage therapy and the injections in my migraine journey. I'll tell you about that later.

What Causes The Pain?

Valerie DeLaune explains it thoroughly in her book Trigger Point Therapy for Headaches and Migraines: Your Self Treatment Workbook for Pain Relief.

She says that trigger points often form where “blood flow is reduced and metabolic wastes are not being exchanged for oxygen and nutrients.”

When this happens repeatedly, the trigger points form knots that you can actually feel in your muscle tissue. These knots then cause pain directly or can cause pain in other parts of your body called referred pain.

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Initially I thought Trigger Point Therapy was just a modality in massage used for muscular pain relief, as an adjunct to Remedial or Swedish massage.

I knew that when you applied enough pressure to the affected areas, for a sufficient amount of time, you could often provide instant relief.

I never related these points directly to a migraine, but if you look at the images here, or these points on myofascial trigger points, they link exactly to where my migraine pain is.

I sure get a lot of neck pain too, how about you?

Many osteopathic doctors now use this technique and administer cortisone or saline injections to these points for immediate pain relief.

Trigger point research, diagnosis and treatment was pioneered by Dr. Janet Travell (1901–1997) and is now widely recommended in the treatment of migraine pain.

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Doctors Travell and Simons' Legacy

Dr. Janet Travell spent over 40 years treating the associated trigger points and the referred pain. Her first book was printed in 1983 when she was 82, which means that she shared over 60 years of knowledge and expertise with us.

Also, while lecturing at the Air force’s School of Aerospace Medicine, her theories impressed a fascinated research scientist named Dr. David Simons (1922–2010) so much, that he retired early from the Air Force to apprentice informally under her.

Together they co-authored Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol. 1. Both doctors were fundamental in bringing the knowledge of trigger points and pain treatment to light.

In 1955, Janet Travell was the doctor that treated President Kennedy’s debilitating myofascial pain and other ailments that threatened ending his bright and promising political career. Having a ripple effect, President Kennedy was her single most important patient that became a walking advertisement advocating for trigger point therapy and pain management.

A Direct Connection Between Trigger Points and Migraines

Their book cites a number of studies that indicate a direct connection between trigger points in the muscles and migraine headaches (Calandre et al. 2006). Calandre et al’s 2006 study compared healthy control subjects who experienced occasional tension headaches with subjects that suffered from regular migraines.

The same trigger points associated with headache and migraine were pressed or stimulated in each subject.

The outcome was that the ‘healthy’ subjects did not experience any migraine like pain from the referred pain patterns.

Whilst the migraineurs did experience their symptoms and pain like throbbing sensation, “light and sound sensitivity and other symptoms that were common for that person” during a migraine attack. It recreated their attack so to speak.

The study results showed that 29% of the healthy subjects did not experience migraine quality of pain in the same trigger points that reproduced their referred pain patterns. 93.9% of the migraine subjects using the same trigger points with referred pain but did have migraine pain and symptoms reproduced.

In fact, 30.6% of the migraine subjects actually had a full blown migraine attack which required urgent treatment from pressing these associated trigger points. Not really a surprise for me, as I had a similar experience.

The researcher also discovered that the more chronic long term migraine cases had a greater number of trigger points in their muscles. 

It is widely known that trigger points can cause other symptoms like: dizziness, vertigo, diarrhea, painful periods, colic, and heart palpitations, just to name a few.

It may depend on your sensitivities as a migraine sufferer to determine if this is indeed a trigger for you. And you may risk causing an attack whilst experimenting. But if you can find the balance to release the knots causing pain and move towards a pain free life, well... it sounds like it's worth a try as far as I am concerned.

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Is Trigger Point Therapy Worth Trying?

Personally, I've not heard of any Migraine Doctor's or specialist's recommending this particular alternative therapy. But I trust the evidence presented above.

In my desperation to find some relief, (years ago) I went to The Headache Clinic in Sydney run by a physiotherapist (headache 'specialist'). His method was to recreate my migraine whilst on his table. Yes - I know - who wants more migraines.

But I persevered with high hopes it would work. But after 8 months I decided this was not my 'cure'. The torture we put ourselves through in the search for some relief.

A few years ago (2012) I had several myofascial release treatments from a musculoskeletal specialist and then 4 treatments of red plasma injections (into trigger points), 6 weeks apart. This was a completely different experience.

The release treatments helped immensely with the body pain, but I am sad to say they had no effect on my migraines.

I still think trigger point therapy is worth trying just in case you fall into the percentage it works for. Do not let my results sabotage your own chance at having a pain free life! Every body is different.

Ways to Prevent Attacks

You will have the best chance at aborting an attack if you approach it from a few different angles and combine therapies.

Along with regular exercise like Yoga, this combination works for me. Read more about them here:

Until next time, be well.

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<sub>Trigger Point Therapy References:
1. Davies, C. (2006) Biographical Sketches [Online], Available at: www.triggerpointbook.com and the book below;
2. Davies, C., Davies, A., and Simons, D. (2008) The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief (2nd Edition). New Harbinger Publications: CA.
3. DeLaune, A. (2008) Trigger Point Therapy for Headaches and Migraines: Your Self -Treatment Workbook for Pain Relief. New Harbinger Publications: CA. Chapter 3 reproduced by permission at Trigger Point Relief and the full book at amazon.com.
4. MyoRehab (2012) Head and Neck Pain [Online], Available at: Triggerpoints.net.
5. Tortora, G. and Grabowski, S. (2000) Principles of Anatomy and Physiology (9th Ed.). John Wiley & Sons, Inc.: USA.</sub>

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