Dry Needling for Forehead Headaches: Top 5 Muscles to Consider

Muscles of the neck can refer pain into the head causing you to have a headache. It can be daunting to try and figure out which muscle is the problem. Thankfully, we have evidence to tell us where a muscles will typically refer to. Of course, there will always be individuals who have atypical referral patterns. The following muscle patterns will be what most people experience. An evaluation by a physical therapist who specializes in treating headaches will be able to accurately evaluate your unique situation.

Sternocleidomastoid

This name is a mouthful and most clinicians will refer to it as the SCM (as you can see, for good reason). This muscle attaches the bone behind the ear, runs diagonally down the sides of the neck and attaches to the sternum and collarbone. The typical referral areas:

• Forehead (both sides)
• Side of the face
• Tip of the chin
• Top of the head
• Inside the ear

If you have developed headaches after an injury (concussion or neck), this muscle should always be evaluated.

Frontalis

This muscle resides on the forehead and is responsible for wrinkling your forehead. It projects pain right where it is located – the forehead.

Masseter

This muscle is located in the jaw and is should be considered if you know you grind and clench your jaw. Typical referral areas:

• Jaw
• Temple
• Ear
• Forehead

Upper Trapezius

This is another muscle to asses if you developed headaches after an injury. It is a large muscle that run from the base of the skull down towards the shoulder. Typical referral areas:

• Side of the neck
• Temple
• Forehead

Suboccipital Muscles

These muscles are a group of small muscles between your skull and the top of your neck. Typical referral area:

• Back of head
• Temple
• Behind the eyes
• Forehead

Treatment Options:

Most of these muscles can be treated rather quickly with dry needling. The exception is the suboccipital muscles. Because these muscles are located close to vital structures, most of the muscles in this group should be treated conservatively with manual trigger point release. If you have tried dry needling and just absolutely hate it, your physical therapist can perform trigger point release to relax these muscles. I cannot stress enough, that you need to find a specialist to evaluate you. A general orthopedic physical therapist is likely not going to have the specialized training and hands on skills to adequately evaluate and treat your neck pain and headaches. A jack of all trades is a master none.