Myodural Tension Syndrome: The Missing Link in Chronic Headaches and Neck Pain

Rethinking Chronic Headaches and Neck Pain: Are We Missing the Real Cause?

If you suffer from persistent headaches, neck tightness, dizziness, or visual strain, you’ve likely been told it’s stress, migraines, or poor posture. You may have tried painkillers, massage, even neurologist referrals with little long-term relief. But what if the root cause is neither in your brain nor your muscles alone—but in the overlooked bridge between them?

At Movability, we specialize in uncovering the real drivers behind complex pain syndromes. One such underdiagnosed cause is Myodural Tension Syndrome (MTS), a condition rooted in the anatomical and fascial connections between your neck muscles and the central nervous system.

What Is Myodural Tension Syndrome?

Myodural Tension Syndrome refers to a mechanical dysfunction involving the myodural bridge complex (MDBC)—a group of deep neck muscles that directly connect to the spinal dura mater, the tough membrane surrounding your brain and spinal cord.

These muscles include:

  • Rectus capitis posterior minor (RCPm)

  • Rectus capitis posterior major (RCPM)

  • Obliquus capitis inferior (OCI)

Their fascia extend through the posterior atlanto-occipital and atlanto-axial membranes, fusing with the dura. This unique anatomical relationship means that chronic tension in these muscles can pull on the dura, leading to pain, neurological symptoms, and even altered cerebrospinal fluid dynamics.

The Anatomy and Biomechanics Behind MTS

The suboccipital muscles act as stabilizers for head and neck movement. Embedded within a dense fascial network, they also play a critical role in proprioception and dural tension regulation.

When these muscles become tight or dysfunctional—often due to poor posture, trauma, or prolonged stress—they transmit abnormal mechanical tension to the dura. This can result in:

  • Cervicogenic headaches

  • Suboccipital pressure or burning pain

  • Headaches that radiate into the eyes, temples, or forehead

  • Visual disturbances or dizziness

  • Exacerbation with head movement or sustained postures

Moreover, MTS may interfere with cerebrospinal fluid (CSF) circulation, as the dural system is connected to the flow of fluid that cushions and nourishes the brain.

Symptom Patterns and Commonly Overlooked Clues

Patients with MTS often present with symptoms that don’t quite fit into traditional diagnostic boxes:

  • Unilateral headaches that worsen with neck movement but don’t respond to migraine medication

  • Tension-type headaches that return despite regular massage or muscle relaxants

  • Dizziness or balance issues triggered by turning the head

  • Eye strain or visual fuzziness without any ocular pathology

  • Neck pain without visible disc or joint abnormalities on imaging

What’s often missed is the subtle restriction or hypertonicity in the C0–C2 region of the cervical spine, and the fascial tug transmitted through the myodural bridge.

Why Conventional Approaches Fall Short

Most conventional treatments target symptoms:

  • Painkillers reduce inflammation but don’t address mechanical tension.

  • Botox or nerve blocks might mute the pain temporarily but ignore the structural cause.

  • Physiotherapy may help posture but rarely targets the suboccipital myodural interface.

Furthermore, standard imaging (like X-rays or basic MRIs) typically overlooks fascial dynamics and muscle-dural interactions unless specifically assessed.

This is where Movability’s integrative, root-cause approach stands apart.

How Movability Diagnoses and Treats MTS: A Root-Cause Approach

At Movability, we start by acknowledging what others often miss: that chronic pain is usually multifactorial. Our collaborative care team—comprising chiropractors, physiotherapists, massage therapists, and naturopaths—works together to uncover and treat the mechanical, neurological, and systemic contributors.

Our Process:

1. Comprehensive Assessment

Dr. Sina and his team conduct a detailed history and physical examination, including:

  • C0–C2 mobility testing

  • Palpation of suboccipital trigger points

  • Neural tension testing

  • Postural and functional movement assessment

If needed, advanced imaging or lab testing is ordered to rule out other contributing conditions (e.g., hypermobility, dysautonomia, CSF leaks).

2. Manual Therapy for Fascial Release

We use targeted manual techniques to release fascial adhesions and muscular hypertonicity:

  • Suboccipital myofascial decompression

  • Joint mobilizations or gentle adjustments at C0–C2

  • Craniosacral therapy and neurofascial release

3. Stabilization and Neuromotor Retraining

Treatment includes:

  • Deep cervical flexor training

  • Scapular and thoracic stabilizer strengthening

  • Sensorimotor retraining to restore head-neck proprioception

4. Integrative Support

Our naturopath may support dural tissue healing and inflammation reduction with:

  • Magnesium and B-vitamin support

  • Adaptogens for nervous system regulation

  • Anti-inflammatory nutrition plans

Who Benefits Most from This Approach?

We frequently see MTS in patients with:

  • Post-concussion syndrome

  • Chronic tension or cervicogenic headaches

  • Whiplash-associated disorders

  • Ehlers-Danlos syndrome or other hypermobility conditions

  • Desk workers with severe forward head posture

Many of these patients come to us after seeing multiple specialists without answers. For them, addressing the myodural connection is the turning point in their recovery.

A Final Word from Dr. Sina

At Movability, we believe no chronic condition should remain a mystery. Myodural Tension Syndrome is not a fad or fringe diagnosis—it’s an evidence-backed explanation for a wide range of complex symptoms. By treating the root mechanical and fascial dysfunctions, we help patients get long-term relief and avoid unnecessary medications or invasive procedures.

Contact Movability today to book a comprehensive assessment and experience our results-driven approach.

Sina Yeganeh