Occipital headaches are a common patient complaint. Sometimes, an occipital headache can signify an underlying condition that can be treated with massage and bodywork techniques, followed by acupuncture.

From a biomechanical perspective, a soft-tissue injury, whether old or new, develops tension patterns within the myofascial system that creates stress and pulls on the skeletal system. This misalignment results in a musculoskeletal imbalance and poor habitual body mechanics, which can subsequently cause pain or, in this case, a nagging occipital headache. Stress, either emotional and/or physical in origin, is the root of many health conditions and disrupts the smooth circulation of defensive qi. Basic massage and bodywork techniques can significantly reduce an occipital headache, thus allowing a refined acupuncture treatment plan.

In Massage for Orthopedic Conditions, author Thomas Hendrickson writes: "Two types of headaches are associated with muscle tension: the occipital headache and the tension headache. The occipital headache develops from sustained contraction of the semispinalis capitis. The semispinalis capitis can entrap the greater occipital nerve, leading to pain, numbness, and burning from the occipital region to the top of the head."¹

According to Travell and Simons, "The predominant theory historically has been that tension-type headaches are due to sustained contraction of cervical and pericranial muscles."²

Palpation is necessary to help locate and identify Ashi points and tender points on muscle. Begin with gentle pressure during palpation to avoid further discomfort to the patient. Palpate the area, feeling for soft-tissue mobility and texture. Tender spots indicate potential Ashi points.

Traditional Chinese medicine recognizes that the occipital headache is due to wind-cold invading the greater yang channels. In The Practice of Chinese Medicine, Giovanni Maciocia states: "Cold contracts and tightens the sinews and slows down the circulation of defensive qi, hence the typical feeling of stiffness at the back of the neck."³

Begin the massage and bodywork treatment with the patient in supine position. The acupuncturist will be seated at the head of the patient. Slight use of massage lotion will facilitate a smooth transition between strokes and promote client relaxation. If the patient has a phobia of needles, massage can further help reduce anxiety.

Easy Guideline for Occipital Headache Relief

1. Palpate GB20, DU16, DU15, UB10, Ashi. Identify tender spots.
2. Begin treatment with the most tender spots first, using the pad of the middle finger.
3. Simultaneously massage in a rhythmic circular motion while oscillating in and out on the surface of the muscle.
4. Travel along the occipital base, from mastoid process to mastoid process.
5. When the soft muscle softens, warmth will be generated.
6. End with manual traction:

A. Hand 1 - Curl finger pads under base of occiput; use the occipital base as a lever.
B. Hand 2 - Place medial palmar surface slightly under chin.
C. Simultaneously, gently motion Hand 1 and Hand 2 forward toward your (the practitioner's) chest. This motion will be the traction.

Utilizing both Western and Eastern principles to treat occipital headaches promotes rapid recovery and effective and efficient treatment plans. Try integrating massage and bodywork into your treatments, and experience the results yourself. It adds a new inviting dimension to your medicine.

References

1. Hendrickson T. Massage for Orthopedic Conditions. Baltimore: Lippincott, William & Wilkins, 2003.
2. Travell J, Simons DG. Myofasical Pain and Dysfunction: The Trigger Point Manual, Vol. 1, 2^nd ed. New York: Williams & Wilkins, 1999.
3. Maciocia G. The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs. New York: Churchill Livingstone, 1994.

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