Headache at the Back of the Head: Causes and When to Seek Help
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Pain in the back of your head can come from many causes. From muscle tension to infrequent headaches and even nerve-related issues, a thorough assessment by a qualified medical professional is needed to determine the cause and prescribe suitable treatments. If you experience persistent or recurring headaches in the back of your head, seek medical attention immediately.
What Does a Headache at the Back of the Head Feel Like?
Depending on the root cause, you may experience different sensations or symptoms. For some people, it may be a dull ache that radiates from the back of the head towards the ears, neck, and even the shoulders and upper back. For others, it may be characterised by sharp, stabbing pain or a burning sensation that comes and goes.
There is no single answer to how a headache at the back of the head really feels. Seek immediate medical care if your headache symptoms are interfering with your daily life.
Common Causes of a Headache at the Back of the Head
Below are some common causes of headaches at the back of your head.
Head/Neck Injury
A direct injury to the back of your head or neck can cause pain, discomfort, and other symptoms that may seem like a headache. These may occur after an accident, a fall, or a workplace- or sport-related injury. The pain may feel like a dull or sharp ache, depending on the injury’s location and severity.
Mild injuries often resolve on their own, but moderate to severe injuries require prompt medical attention to prevent concussion-related or other complications.
Tension Headache
Tension headaches are one of the more common headaches at the back of the head. You may often feel it on the back and right side of your head, though it may also present itself as a constant pressure or tension around your head. It may feel like a tight, gripping pain or a steady, dull ache, often remaining at a constant level that may be frustrating to manage.
Tension headaches are usually caused by stressors such as anxiety, depression, and even anger, often occurring during or after a particularly stressful day. These stressors may trigger sudden muscle tightening in your neck or scalp, which can lead to these headaches.
Neck Strain/Poor Posture
Neck strain can result from various causal factors, with poor posture while standing or sitting being one of the most common causes. Poor positioning may put pressure or tension on specific parts of your head, neck, shoulders, and back. This, in turn, causes muscles in the back of your head to contract and tighten, gradually causing pain and discomfort.
Simple posture changes and supportive methods (such as using a suitable pillow) may help alleviate these strains, thereby reducing the intensity and duration of your headaches.
Migraine
A migraine is a severe headache characterised by a throbbing, pulsing pain on one (or, rarely, both) side(s) of your head or body. It generally occurs due to abnormal brain activity that overstimulates nerves, which can affect nerve pathways, chemicals, and blood vessels in the brain. A migraine attack can last anywhere from a few hours to a few days, with some attacks being so severe they could prevent you from performing daily activities. Some migraines may present early symptoms before an attack begins (classic migraines), while others (common migraines) may not.
Certain triggers, such as stress and smoking, could cause a migraine to manifest, and triggers often vary from person to person. A migraine may also be accompanied by other symptoms, including subtle mood changes, fatigue, sudden vision changes, and potentially nausea and vomiting. Chronic cases that occur at least 15 days per month, with at least eight of these days presenting migraine symptoms, require immediate medical attention.
Occipital Neuralgia
Occipital neuralgia is a form of nerve pain due to trauma or inflammation of the occipital nerves, which run from the spinal cord to your scalp. It may present as a sharp, aching, or throbbing pain from the base of the head in your neck and radiates towards your scalp. The condition may result from a pinched nerve, degenerative disc disease, muscle tension, or another cause. As it may stem from a severe condition, you should see a doctor immediately for a prompt diagnosis to determine (and subsequently treat) the cause.
Occipital neuralgia may also cause unexpected vision changes, pain or pressure behind the eyes, tinnitus (ringing in the ears), and other symptoms. If not treated, the pain you experience may feel like an electric shock and linger for some time.
Cervicogenic Headache
This type of headache may feel like it occurs in the back of your head, but it actually stems from the upper back and neck. A cervicogenic headache is often considered a secondary headache, which is caused by an underlying condition, such as muscle strain, a pinched nerve, or a herniated disc. The pain may begin around the base of your head, close to the neck, before spreading towards the back of your scalp.
A thorough diagnosis is necessary to rule out other possible causes and determine if you do have a cervicogenic headache.
Cluster Headache
A cluster headache is a severe form of headache that occurs during “cluster periods”, characterised by multiple attacks within a short period and repeats over several weeks. They often affect the area behind your head or eyes, marked by a rapid onset of pain that grows in intensity and lasts several hours. The pain is often described as a “burning, stabbing, drilling, or squeezing sensation.” In some cases, the pain may worsen when you lie down or can be triggered by stress, alcohol, or other possible triggers.
A cluster headache may also cause other symptoms, including a runny nose, facial redness, and excessively watery eyes.
Diagnosing the Cause of a Headache at the Back of the Head
A detailed diagnosis is required to accurately determine the nature and cause of your headache at the back of the head. A physical examination is the first step in determining the cause of your headache, allowing the doctor to carefully examine your head for warning signs or other important details. They will also review your medical history to look for anything that could point towards the cause of your headache. A neurological examination may also be performed to assess your nervous system’s condition and confirm the doctor’s initial diagnosis.
Diagnostic tests are often performed to rule out specific causal factors or to look for signs or clues that will help confirm the diagnosis. These tests may include:
- Blood work: Blood tests may help to identify or rule out certain headaches or conditions that could contribute to your headache at the back of your head.
- X-rays: A doctor may use X-rays to look for damage to surrounding bones or dense structures that may potentially be causing your headache at the back of your head.
- CAT/MRI scans: These imaging tests create clear images of various tissues and other structures of your head, allowing doctors to determine the cause of your headache.
When Should You See a Doctor?
While a headache should subside after some time, if it persists or recurs, or if the pain is significant enough to hinder your daily activities, it may be wise to seek prompt medical attention.
If you experience any of these symptoms, have a qualified doctor examine your condition immediately.
- Pain or tenderness when talking, chewing, or applying mild pressure to your jaws, temples, or other parts of your head.
- Sudden high fever that does not go away.
- Persistent or recurring headaches when sitting or lying down.
- Slurred speech.
- Bouts of confusion.
- Sudden weakness or drowsiness.
- Sudden loss of balance when standing or walking.
- Numbness around the back of your head.
- Any sensations you experience that feel unusual to you.
Treatment Options for a Headache at the Back of the Head
Headaches can be properly treated and managed with the support of a qualified medical team.
Lifestyle Changes
Mild headaches at the back of your head are often treatable with various lifestyle changes as advised by your doctor.
- If your headaches are caused by dehydration, drink plenty of water throughout the day.
- Set a regular schedule of physical activities to reduce headache frequency and maintain your well-being. Avoid exercising in very hot or cold weather.
- When starting any new physical activities, start slow and gradually increase your duration, frequency, and intensity. Do not rush it, as you could trigger a headache as a result.
- Enjoy a well-balanced diet at regular intervals, and cut down on unhealthy fats, sugars, sugary beverages, alcohol, and caffeine. If certain foods or drinks may trigger headaches, avoid or limit your consumption of those as well.
- Maintain a healthy weight, as obesity is associated with an increased risk of headaches.
- Get at least eight hours of sleep every day, and go to bed at a consistent time. Avoid using any devices before bedtime to ensure you can sleep soundly.
- Practice relaxation techniques, such as yoga and meditation, to help you de-stress. It also helps to partake in your favourite activities or hobbies.
- Sit and stand properly to maintain good posture and reduce muscle tension, especially if you work a desk job for long hours. Adopt proper posture when lifting heavy objects as well.
- Keep a record of possible headache triggers and notify your doctor if you notice any changes or new bouts of headaches.
- If heat triggers your headaches, wear comfortable clothing and adopt sun-safe behaviours, such as using an umbrella on sunny days.
Medications
Medications may be prescribed to treat symptoms during a migraine attack or prevent them from happening. Your doctor will prescribe suitable medicines based on your treatment needs, with medications typically including non-steroidal anti-inflammatory drugs (NSAIDs), anti-emetics to help you cope with certain ailments, and triptans that block pain pathways in the brain.
Hot and Cold Packs
Alternate between hot and cold pack use to alleviate your headaches. Hot packs are suitable for relaxing tight muscles and promoting blood circulation, which may ease headache intensity and stiffness. Conversely, cold packs treat inflammation and alleviate pain by narrowing blood vessels for headache relief. Consult your doctor on how to use each type for specific headaches.
Other Treatments
If the headache is due to another underlying condition, such as a pinched nerve, other treatments will be recommended based on your condition. For example, pinched nerves may stem from a herniated disc, which may require a microdiscectomy to remove a portion of the herniated disc pressing on the nerve root or spinal cord.
Your doctor will discuss your available treatment options in detail to help you understand the treatment’s purpose, potential risks, and side effects, as well as answer any questions you may have about your options. If you are seeking support for headaches at the back of your head, contact Avant Orthopaedics today to find out how we can support your treatment journey.
Our Doctor for Headache and Migraine Relief
Dr. Hope Ang
MBBS (NUS) | MMed (Anaes) | FAMS
Dr Hope Ang is a Consultant Anaesthesiologist with extensive expertise in acute and chronic pain management, dedicated to helping patients regain function, reduce suffering, and improve quality of life through evidence-based, personalised care.
With more than 18 years of clinical experience, Dr Ang specialises in the assessment and treatment of complex chronic pain conditions, including musculoskeletal pain, neuropathic pain, cancer-related pain, and persistent postoperative pain. His approach integrates interventional pain procedures, ultrasound-guided regional techniques, multimodal pharmacological strategies, and close collaboration with multidisciplinary care teams to address both the physical and functional impact of chronic pain.
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