A therapist resting her fingertips on the forehead and temples of a client lying face up on the table at Renu

Why do I get a headache after a massage?

A headache after a massage usually comes from dehydration, too much pressure, a scent or product, or standing up too fast. Here is how to prevent it.

By The Renu lymphatic and massage team · 5 min read

A headache after a massage usually has one of four everyday causes: not enough fluid on board, pressure that was firmer than your body wanted, a reaction to a scent or product in the room, or a dip in blood pressure when you stood up from the table. All four are preventable, and none means you have to give up massage. A sudden, severe headache or one with fever, a stiff neck, confusion or weakness is a different matter and needs urgent care.

You floated out of the room, and two hours later your head was pounding. It is a frustrating way to end a treatment that was meant to help, so let us work through what is most likely going on. The good news is that each cause has a straightforward fix.

The four usual causes

Healthline and Medical News Today, between them, name the same short list. Most post-massage headaches come down to one of these.

Not enough fluid

Dehydration on its own causes headaches, as Cleveland Clinic lists among its symptoms alongside dizziness and tiredness. If you arrived at your appointment already low on fluid, perhaps after coffee, a workout or a hot day, an hour of muscle work and lying still can be enough to tip you into a headache. Healthline’s suggestion is to drink at least eight ounces of water before and after a session.

More pressure than your body wanted

Healthline is direct about this one: too much pressure can cause sore muscles, muscle bruising and increased blood circulation, and that combination may trigger a headache. Medical News Today describes the same mechanism as a pressure headache. Deep tissue and trigger point work on the neck and shoulders are the most common culprits, which is why both sources suggest speaking up about pressure early rather than enduring it.

A scent or product in the room

Massage rooms are full of smells. Healthline points to cleaning agents, perfume, incense, laundry detergent and the ingredients in massage oil as possible triggers for anyone who is sensitive or allergic. Medical News Today adds that strong oils and perfumes can set off or worsen migraines, and that an allergic reaction to an oil is associated with sinus headaches. Cleveland Clinic’s general headache page lists strong odours from household chemicals or perfumes among common triggers, so this is not specific to massage; the treatment room simply concentrates them.

At Renu the skincare we use on the table is from Om Organics, and if you have ever reacted to a scent or an ingredient, tell us before your session so we can keep your room as plain as possible.

Standing up too quickly

After an hour lying flat and deeply relaxed, standing up can produce a brief drop in blood pressure. Cleveland Clinic defines orthostatic hypotension as a fall of more than 20 mmHg in the top number, or 10 mmHg in the bottom number, within three minutes of standing, and lists dizziness, blurred vision, weakness and headache among its symptoms. Dehydration and blood pressure medication both make it more likely, so the causes on this page tend to stack.

How to prevent the next one

Most of these steps come straight from Healthline’s prevention list, with a couple added from Medical News Today and Cleveland Clinic.

Drink at least eight ounces of water before and after the session, and a little more than usual for the two days after
Skip alcohol the night before and the night of your massage
Tell your therapist you are prone to headaches, and agree a pressure level before you start
Say something the moment the pressure feels like too much; the detail is on our page about how much pressure a massage should have
Ask for unscented products and a fragrance-free room
Have a light snack afterwards rather than leaving on an empty stomach
Sit up slowly, pause on the edge of the table, and stand only when the room is steady
Consider a lighter style, or a shorter session focused on one area, if full-body deep work keeps setting you off

If you are also waking up stiff the day after, that is a separate pattern, covered on Is it normal to be sore after a massage?.

If the headache has already started

Medical News Today’s advice is simple and sensible: rest, drink water, put a cold compress on your forehead, and if needed take an over-the-counter pain reliever such as ibuprofen or naproxen. Rubbing the temples gently can help too. For most people the headache clears the same day.

What you do not need to do is “flush toxins”. Massage does not release toxins into your bloodstream, and framing the headache that way tends to lead people away from the fix that would actually work. We cover the hydration question honestly on Do I need to drink extra water after a massage?.

When a headache needs a doctor

Nearly all headaches after a massage are harmless and short-lived. A small number are not about the massage at all, and the signs below should be treated as urgent regardless of what you did that afternoon. Cleveland Clinic and the NHS both list them.

Seek emergency care for:

A sudden, new and severe headache, the worst you have had
A headache with fever and a stiff neck, or with a rash
Weakness, numbness or tingling, trouble speaking, confusion or a seizure
Vision changes or loss of vision
A headache following a head injury

See your doctor if headaches after massage keep happening despite the changes above, if your headaches are becoming more frequent or more severe than usual, or if painkillers are not helping. Taking too many painkillers is itself a cause of headaches, according to the NHS, so repeated self-treatment is worth a conversation.

Migraine is its own question

If what you get after a session is a migraine rather than an ordinary headache, with throbbing on one side, sensitivity to light and sound, and a duration of hours, it deserves its own planning. Our page Can a massage trigger a migraine? looks at that specifically, including scent and neck work as triggers.

For everyone else: a glass of water, a quieter room, a lighter hand and a slow sit-up will usually be all it takes. Tell us at your next massage appointment and we will plan the session around it.

Questions people ask

Is a headache after a massage a sign of toxins being released?

No. There is no evidence for a release of toxins after massage, and the headache has more ordinary explanations: fluid, pressure, scent or the change in blood pressure when you stand. Treating it as a detox symptom means missing the thing you could actually fix next time.

Should I stop getting massages if they give me headaches?

Usually not. Work through the four causes first: drink water before and after, ask for lighter pressure, request a fragrance-free room, and sit up slowly at the end. If the headaches continue even with those changes, talk to your doctor before booking again.

What can I take for a headache after a massage?

Medical News Today lists rest, water, a cold compress on the forehead and an over-the-counter pain reliever such as ibuprofen or naproxen as sensible options. Check with a pharmacist if you take other medication or are pregnant. If the headache is severe or unusual for you, skip the painkiller and seek care instead.

Why do I feel dizzy and get a headache when I get off the table?

That pattern points to orthostatic hypotension, a short drop in blood pressure when you stand after lying flat. Cleveland Clinic lists dizziness, blurred vision and headache among its symptoms, and dehydration and blood pressure medication among its causes. Give yourself a minute sitting on the edge of the table before you stand.