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.