Objective: To investigate the effects of Thai traditional massage (TTM) on pressure pain threshold (PPT) and headache intensity in patients with chronic tension-type and migraine headaches.

Design: Randomized controlled trial of TTM compared with the sham ultrasound (nine sessions each) during a 3-week period.

Participants: Seventy-two participants who had had a headache diagnosis for at least 3 months before the experiment was recruited.

Results: After the treatment and at 3 and 9 weeks of follow-up, the TTM group showed a significant increase in PPT (p < 0.01) compared with the sham ultrasound group. PPT values at baseline, after 3 weeks of treatment, and at 3- and 9-week follow-up for the TTM group were 2.71 ± 1.22, 3.57 ± 1.41, 3.72 ± 1.46, and 3.42 ± 1.46 pounds/cm2, respectively; values in the sham ultrasound group were 2.85 ±1.20, 2.62 ± 1.07, 2.58 ± 1.05 and 2.63 ± 0.94 pounds/cm2. In both groups, headache intensity decreased significantly ( p < 0.05) at every end point of the outcome measures, and there were no differences between the groups ( p > 0.05).

Conclusions: TTM could increase PPT and reduce headache intensity, suggesting that this is a possible alternative treatment for chronic headaches.