In general, it is difficult to pinpoint the precise cause of an infrequently occurring muscle tension or vascular headache, but sometimes the anatomy of the headache—how it starts, where the pain is felt, and how long it lasts—provides valuable clues about its source.

It was once believed that there were only two simple origins of headaches. Vascular, such as migraines, occurred when blood vessels that supplied the brain and muscles of the head and neck dilated or were constricted. Tension headaches were thought to result from the tensing and contracting of muscles of the head, face, and neck in response to physical stress, such as injury or emotional distress.

However, it is now understood that there are complex chemical changes in the brain associated with pain. Tension headaches are associated with neurochemicals in the brain —varying levels of serotonin, endorphins and other chemicals that serve as neurotransmitters (substances that nerves use to send messages to one another) helping nerves to communicate.

These chemical changes observed in headache sufferers may cause, or be caused by, muscle tension. It is possible that tensed muscles in the neck and scalp may trigger a headache in someone with altered neurochemical levels or, on the other hand, the neck and scalp muscles may be tensing in response to these neurochemical changes. It is understood that the varying levels of these chemicals are thought to activate pain pathways to the brain and also to actually interfere with the brain's own ability to suppress the pain. By adopting the benefits of massage therapy, muscle tension can be eased thus reducing the causes of headaches.

As headaches often result from or involve pain referred from problems associated with the bones and muscles in the neck, shoulder, and back, massage focusing on the cervical spine (the vertebrae in the neck behind the skull) can help to relieve headache pain. Shiatsu massage, a technique originated in Japan whereby pressure applied by the fingers, thumb and palm of the hand to acupuncture points, can have a beneficial effect to reduce the headache pain. Another therapeutic touch technique that seems to help sufferers is known as the Trager Approach. This techniques uses massage to literally stretch the body's muscles and joint in order to enhance relaxation.

Some tension headaches may be relieved by a specific form of massage therapy called trigger point therapy (TrP). Trigger point therapy is the application of pressure to specific points such as along the trapezius muscles (the muscles extending from the base of the skull to mid-back located along the spine) and sternocleidomastoid muscles (muscles on either side of the neck). This pressure interrupts the nerve signals that not only cause the headache pain but also create the trigger point. This massage therapy aims to relieve pain and to re-educate the muscles so they assume healthy positions and postures that do not generate pain. The beneficial effect of the manipulation of the body's muscles through massage is a recognised method of treating the causes of headaches through natural methods. Whether a full soothing body massage or therapy concentrating on the back and neck, facial or head, the techniques used can reduce stress levels and improve blood circulation leaving the person feeling relaxed and refreshed.