Post-Massage Head Pain: Is It a Sign of Vertebral Artery Dissection?

Headache and dizziness after massage?

I went for a massage yesterday and asked the therapist to work on the muscles around the occipital area.
However, he applied too much pressure, and now the massage point is painful.
Is there a possibility of vertebral artery dissection? Currently, I have no other neurological symptoms, just pain.
Will the mild dizziness resolve on its own?

YI, 20~29 year old female. Ask Date: 2021/11/09

Dr. Jiang Junyi reply Neurology

Hello Mr.
Yi,
You mentioned, "Could the pain at the massage point possibly indicate vertebral artery dissection?" Generally, issues with the vertebral artery occur after severe rotation, and localized pressure is less likely to cause such problems.
More than half of patients with vertebral artery dissection have hypertension.
When it occurs, in addition to severe headaches, most patients will experience mild neurological symptoms such as dizziness, slurred speech, weakness in the limbs, drooping eyelids, or facial paralysis.
Your symptoms may suggest a problem with muscle inflammation.
For nerve repair, it is recommended to supplement with B vitamins and control risk factors.
Avoid smoking, among other things.
If symptoms persist, it is advisable to consult a neurologist for discussion, examination, and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2021/11/09

More Info

Post-massage head pain can be concerning, especially when it follows a vigorous massage of the neck and occipital region. While it is understandable to worry about serious conditions like vertebral artery dissection (VAD), it is important to consider the context and the nature of your symptoms.

Vertebral artery dissection is a rare but serious condition that occurs when there is a tear in the artery wall, which can lead to a stroke. Symptoms of VAD can include sudden onset of severe headache, neck pain, dizziness, visual disturbances, and neurological deficits. However, the pain you are experiencing after a massage, particularly if it is localized and not accompanied by other neurological symptoms, is more likely to be related to muscle strain or tension rather than a vascular issue.

When a massage is performed, especially in the neck area, it can sometimes lead to muscle soreness or tension due to the manipulation of the soft tissues. This soreness can manifest as a dull ache or sharp pain in the area that was massaged. If the massage was particularly intense, it could have caused muscle strain or irritation of the surrounding tissues, leading to discomfort. This is often referred to as "post-massage soreness" and is generally not a cause for alarm.

In your case, since you mentioned that you are not experiencing any other neurological symptoms—such as weakness, numbness, or changes in vision—this further reduces the likelihood of a serious condition like VAD. The mild dizziness you mentioned could be a result of muscle tension or even anxiety related to the pain, rather than a direct indication of a vascular issue.

To manage your symptoms, consider the following:
1. Rest: Allow your body some time to recover. Avoid any activities that may exacerbate the pain.

2. Ice or Heat: Applying ice to the sore area can help reduce inflammation, while heat can help relax tense muscles. You can alternate between the two based on what feels better for you.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.

4. Gentle Stretching: Once the initial pain subsides, gentle neck stretches can help relieve tension and improve mobility.

5. Hydration: Ensure you are well-hydrated, as dehydration can sometimes contribute to headaches and dizziness.

6. Monitor Symptoms: Keep an eye on your symptoms. If they worsen or if you develop new neurological symptoms, it would be prudent to seek medical attention promptly.

If your pain persists or if you have any concerns about your symptoms, it is advisable to consult a healthcare professional. They may recommend imaging studies, such as an MRI or CT scan, to rule out any serious conditions if deemed necessary.
In summary, while it is natural to be concerned about the possibility of vertebral artery dissection following a massage, the absence of significant neurological symptoms and the nature of your pain suggest that it is more likely related to muscle strain or tension. Taking care of yourself and monitoring your symptoms will be key in your recovery.

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