Relaxing the scalp

May 28, 2022 2:05 PM

My scalp muscles have felt tight and sore for years. I've tried the obvious (posture, tension headache meds, massages, anxiety meds and therapy, yoga/stretches). What else should I try?

It started as part of bad tension headaches brought on by bad computer posture and stress years ago, and I've got those mostly under control with Elavil and better posture. I've tried

1. a variety of other meds (including muscle relaxants, Botox administered as instructed for migraines, various stuff that makes you sleepy/relaxed)
2. massages (feels really good but ultimately doesn't do much when massage is over)
3. neck/shoulder stretches/strengthening/yoga (I now have good computer/phone/etc. posture)

I have anxiety that's under control with various meds (the rest of my body is not tense/sore), and I don't grind my teeth at night. I just have a scalp that is always too tight and a little sore.

YANMD but what else should I try? Has anything worked for you?

posted by rollcredits to Health & Fitness (10 answers total)

Heat often helps me when other treatments aren’t enough. I usually use the old microwaved sockful of rice.
posted by The Underpants Monster at 2:16 PM on May 28, 2022 [1 favorite]

I concur that heat can help and I will share my rice-sock innovation: tie two microwaved socks full of rice together and hang them over your head like a headband for a mostly hands-free microwaved sock experience (I get really tense in/ just behind my temples).
posted by mskyle at 2:32 PM on May 28, 2022 [4 favorites]

Have you ever tried something like the Headache Hat? It’s like a wearable fancy cold pack. Alternating heat and cold can really help muscles relax and encourage circulation. Try using cold to help inflammation and give you pain relief, and then take a long warm shower or heating device like The Underpants Monster suggests, and see how you feel.

Have you been tested for allergies? You might be struggling with an allergic response that mostly expresses itself through headache and congestion. Antihistamines have come a long way and you might be surprised about what environmental factors are stressing your body that you simply don’t think about.
posted by Mizu at 2:36 PM on May 28, 2022 [1 favorite]

Elavil is a standard prophylactic for migraine, and scalp tenderness is common during migraines.

Which suggests that your "tension headaches" are mixed tension migraines, and that your scalp pain is a residual symptom of your headaches. In googling this I saw a couple of reports that "scalp dysaesthesia" can be alleviated by amytriptylene (Elavil), so upping your dose a bit under the guidance of your physician might be worth trying.
posted by jamjam at 4:25 PM on May 28, 2022 [3 favorites]

I think jamajm might be on to something. I am not a neurologist, but I get migraines, and definitely get a lot of scalp tension when I get them. Migraines are a weird beast. They're not actually a headache, but a neurological condition where headache is a common feature. You may want to talk to a neurologist to find out if your symptoms are actually migraine - there are different treatments for migraine than tension headaches.

I see a physical therapist for neck pain, and when I have had a migraine she will do extra work on my scalp. She's also taught me how to do some release myself. You might want to explore physical therapy.

Also agree that heat helps a lot to relax muscles. I prefer a plug-in heating pad because they stay hot longer.
posted by radioamy at 6:48 PM on May 28, 2022 [1 favorite]

A good physical therapist who specializes in headaches can work wonders.
posted by medusa at 6:54 PM on May 28, 2022

I am a neurologist who also gets migraines, and I came in to say what jamjam and radioamy already did.
posted by basalganglia at 7:58 PM on May 28, 2022

I use a gua sha tool on myself to help relieve scalp tension, it works really well. There's lots of videos on Youtube about how to use a gua sha tool, but I didn't find one that shows how I specifically use it: on the scalp, not so much the face. I spend a bit longer on the temples and the jaw and right in front of my ears and it feels amazing. I got mine for less than $10.
posted by stinker at 12:41 AM on May 29, 2022

My partner also has this problem and has recently been getting substantial relief from this Renpho electric scalp massager
posted by knapah at 3:33 AM on May 29, 2022 [1 favorite]

Caffeine cessation and supplementation with high-absorption chelated magnesium (such as Doctor’s Best) at 200-400mg per night are good adjuvants to the Elavil if this is indeed a migrainous phenomenon. Elavil dosing varies widely and effective doses range from 10mg to 75mg nightly in my experience as an ENT doc who treats a lot of migraine (but escalating doses can lead to increased daytime drowsiness and dry mouth. Nortriptylene at the same dose can be as effective with fewer of these adverse effects. Obviously talk to your doc before changing your dose).

Changes in diet/supplements/drugs can take 4-6 weeks to really take effect.
posted by Fritzle at 7:51 PM on May 31, 2022