What Causes Headaches at the Back of the Head

Headaches due to an underlying medical condition are called secondary headaches. This includes infection, severe injury, tumors, bleeding in the brain, and sometimes, even life-threatening causes. Below are a few common types of secondary headaches:

Why Does the Back of My Head Hurt?

If you have pain in the back of your head, you’d probably enjoy some relief. To find a long-lasting fix, you need to find the root of the problem. From poor posture to different types of headaches, the back of your head may hurt due to one of the following causes.

Tension headache. This is the most common type of headache. It happens when the muscles in your scalp and neck tighten. This causes pain on the sides and back of your head. Usually it’s a dull pain that doesn’t throb.

Poor posture. If you tend to slouch when you sit or stand, that can strain the muscles in the back of your head, upper back, neck, and jaw. It also can put pressure on the nerves in those areas. As a result, poor posture can cause tension headaches and pain in the back of your head.

Standing or sitting up straight can help relieve headaches from poor posture. Over-the-counter pain relievers may help as well. In some cases, you may need physical therapy.

Arthritis headache. The main symptom of an arthritis headache is pain in the back of your head that gets worse when you move. It may be the result of arthritis in the first, second, or third vertebra of your spine. It also could be due to changes in the bone structure of your neck or inflamed blood vessels in your head.

Talk to your doctor about treatments. Usually you can treat these headaches with anti-inflammatory drugs, muscle relaxers, or both.

Low-pressure headache. Spontaneous intracranial hypotension (SIH) is more commonly known as a low-pressure headache. This happens when there’s a spinal fluid leak in your neck or back. The leak causes the cushion of spinal fluid around your brain to decrease.

Symptoms of SIH include intense pain in the back of your head and neck that gets worse when you stand or sit. Low-pressure headaches usually get better after you lie down for half an hour. Some people with SIH wake up with a mild headache that gets worse through the day.

See your doctor if you think you have SIH. They likely will use a series of tests and imaging studies to diagnose the condition.

Most SIH patients find that typical headache treatments don’t work. Instead, they rely on a combination of caffeine, water, and lying down.

An outpatient procedure called an epidural blood patch is a common treatment that often works. For this procedure, your doctor draws blood from your arm and injects it into your lower spine. The headache goes away almost instantly, though you may have some lower back pain for up to a week (or in rare cases, even longer).

Occipital neuralgia. This rare type of headache involves pain in the occipital nerves. These run from your spinal cord up to your scalp. When they’re injured or inflamed, you may feel pain in the back of your head or behind your ears.

People describe the pain as stabbing and severe — like a shock. It can last for a few seconds to a few minutes. Afterward, you may feel a dull ache.

Doctors aren’t sure what causes occipital neuralgia . The headache may come on when you do normal activities, such as brushing your hair or adjusting your head on your pillow. People with a whiplash injury or tumor may have it as a side effect.

Treatment generally includes warm compresses and gentle massage. Anti-inflammatory medications and muscle relaxers may help, too. If you have these headaches often, your doctor may prescribe antidepressants or antiepileptic drugs to lessen the attacks.

Cervicogenic headache. This may feel like a headache with pain in the back of your head, but the issue actually is in the neck. This is called referred pain, when you feel the pain in one part of your body but it’s really coming from somewhere else.

These don’t happen on their own — they’re a secondary headache, which means they are a sign of another medical issue. This type of headache means there’s a problem with the bones, disks, or soft tissue in the neck such as:

Tumors
Broken bones
An infection
Rheumatoid arthritis

Symptoms of this type of headache include pain that gets worse with certain neck movements or when you touch your neck. You may find you have a limited range of motion.

To diagnose cervicogenic headaches, your doctor will need to rule out other types of headache. For treatment, they’ll use nerve blocks to numb the nerves in the neck. If this stops the headache, then you’ve found the problem. Other treatments include medication and physical therapy.

Show Sources

National Headache Foundation: “The Complete Headache Chart,” “Tension-Type Headache,” “Arthritis.”

American Migraine Foundation: “What to Know About Low-Pressure Headaches,” “Occipital Neuralgia,” “Cervicogenic Headache.”

Journal of the Japanese Physical Therapy Association: “Effectiveness of Physical Therapy in Patients with Tension-type Headache: Literature Review.”

University of Michigan, Michigan Medicine: “Tension Headaches.”

Mayo Clinic: “Posture: Align Yourself for Good Health.”

What Causes Headaches at the Back of the Head?

Headaches in the back of your head can have a number of different causes; it may only be due to a minor injury or it can be a secondary symptom of other problems in the body. The type and location of the pain can play a crucial role in diagnosing the cause of headaches.

Pain in the back of the head is most commonly caused by tension headaches, which are common and typically not a cause for concern. However, sudden, severe, or recurrent headache pain in this area of the body could be a sign of a serious underlying condition and should be evaluated by a doctor.

Pain originating in any region of the face, head, or neck is called a headache. This pain can be dull or severe and localized to the face, skull, or neck. Headache may sometimes be associated with nausea, vomiting, or dizziness.

What causes pain in the back of the head at the base of the skull?

There are a number of different causes that can lead to headaches that cause pain in the base of the skull. Below are a few types of these headaches:

Tension headaches

Tension headaches are the most common cause of pain in the back of the head. They can last for 30 minutes to 7 days.
Severe stress, fatigue, lack of sleep, skipping meals, poor body posture, or not drinking enough water may cause these types of headaches.
Patients usually feel tightening around the back or front of the head; pain may range from dull to severe.
Treatment includes painkillers, lifestyle modifications, massage, and sometimes relaxing techniques (e.g., meditation). However, frequent tension headaches need a doctor’s supervision for further treatment.

Migraine

Migraine is a common type of recurring headache that often starts during childhood and increases in frequency with age.
It is most commonly seen in females.
Symptoms include severe pain on one side of the head with nausea, vomiting, and visual disturbance. Patients are usually sensitive to light, noise, or smell. Physical activity can make the pain worse. Pain may last for a few hours to several days.
Causes usually include emotional or physical stress, environmental factors, and dietary changes. Sometimes medications (e.g., contraceptive pills) can induce migraine headaches.
Treatment of migraine includes painkillers and resting in a darkened room. Lifestyle modifications, hormonal therapy, and anti-migraine drugs such as triptans are usually recommended by doctors to reduce the frequency and intensity of migraines.

Medication overuse or rebound headache

Medication overuse headaches (MOH) may develop if a person uses too many painkillers.
Symptoms include persistent headaches with severe pain. Usually, headaches restart after stopping painkillers. Other symptoms include anxiety, irritability, tiredness, restlessness, concentrating difficulty, memory loss, and sometimes even depression.
The best treatment is often to stop taking the painkiller entirely. Headaches become worse at first but will quickly resolve. In more severe cases, people should see a doctor. An individual may need physical or behavioral therapy to break the habit of using pain relievers.

Occipital neuralgia

Occipital neuralgia is a rare but severe headache that tends to begin at the base of the neck and spreads up to the head, then behind the ears.
Usually occurs when there is damage or irritation of the occipital nerves, which run up the back of the neck to the base of the scalp.
Underlying diseases, neck tension, or other unknown factors might cause nerve damage or irritation.
Pain is usually severe with a burning or shooting sensation; the pain remains on one side but often worsens with neck movement. The patient would usually be sensitive to light.
Possible causes of occipital neuralgia include damage to the spinal cord, tumors, nerve damage caused by diabetes, swelling of blood vessels, and rarely infection.
Treatment options include applying heat packs, resting, massage, physical therapy, and taking painkillers, which can reduce swelling and inflammation. Severe pain may require drugs, such as oral muscle relaxants, nerve block injections, steroid injections, or local anesthesia. On rare occasions, surgery for occipital neuralgia may be necessary to reduce pressure on the nerves or block pain impulses to this part of the body.

Exercise-induced headaches

Exercise-induced headaches occur as a result of stressed physical activity. Pain may start immediately after exercise.
Symptoms include a heartbeat-like pain on both sides of the head, which can last from five minutes to two days. These headaches are usually isolated events and may also produce migraine-like symptoms.
Causes include weightlifting, running, and sometimes sexual intercourse, or straining on the toilet.
Treatment includes taking painkillers before exercise, avoiding stressful activities, eating and drinking healthy foods, and getting sufficient sleep.

Are headaches in the back of the head normal?

Headaches in the back of your head are typically tension headaches, which are very common and typically not a sign of serious illness. Many factors can cause you to get headaches in this area, and you may be able to prevent them by avoiding certain triggers. Common headache triggers include:

Physical stress
Emotional stress
Alcohol or caffeine
Dehydration
Skipping meals
Changes in sleep patterns
Excessive painkiller use
Poor posture
Illness
Genetics
Environment

When should I worry about headaches in the back of my head?

Headaches can be usually treated at home; however, secondary headaches and headaches causing severe symptoms should be evaluated by health professionals to rule out underlying causes.

If the headache pain you are experiencing is sudden, severe, or accompanied by the symptoms below, consult your doctor to evaluate what could be causing headaches in this area:

Confusion
Memory loss
Loss of balance
Vision changes
Slurred speech
Neck pain or stiff neck
Seizures

QUESTION

What are the different types of headaches?

There are more than 150 types of headaches, either primary like migraines, or secondary as a symptom of illnesses.

The International Headache Society lists more than 150 types of headaches, and based on it headaches are classified into three main categories which include:

Primary headaches

A headache with no clear underlying cause is called a primary headache. It may be due to overactivity or strain. Primary headaches might not be life-threatening but may affect the quality of life. Below are a few common types of primary headaches:

Tension headaches: These occur when the muscles of the face or the scalp become tense. This may be due to physical or mental stress.
Migraine headaches: Migraine pain is moderate to severe and can last from four hours to three days. Multiple factors cause migraines, and they may have a hormonal origin. Migraine symptoms include sensitivity to light, noise, or smell.
Cluster headaches: This headache type is rare but is the most severe type of primary headache. The pain is severe, throbbing, and mostly localized to behind the eye. It may be accompanied by watery eyes and sensitivity to light.

Secondary headaches

Headaches due to an underlying medical condition are called secondary headaches. This includes infection, severe injury, tumors, bleeding in the brain, and sometimes, even life-threatening causes. Below are a few common types of secondary headaches:

Sinus headaches: Sinus headaches are associated with infection of the sinuses. This pain is associated with a deep and constant throbbing in the cheekbones, forehead, or bridge of your nose. The pain usually gets worse with sudden head movement or straining.
Medication overuse headaches: These occur due to taking over-the-counter painkillers too frequently. This is among the most common type of severe headaches seen in hospitals and is also called “transformed” headaches. It is believed that 4% of the population worldwide has chronic daily headaches of some type — a significant subset of which are due to medication overuse.

Other headaches

Any other headaches, facial pain, and pain involving the 12 cranial nerves (nerves supplying from the brain to other parts of the body) are classified in this group.

Trigeminal neuralgia (TN): This is the most common cause of facial pain; pain is so severe that it affects the daily life of the patient leading them to depression.

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Migraine Treatments:
What are your other options?

How do you get rid of a headache in the back of your head?

Below are a few common ways to get rid of headaches:

Get plenty of rest
Drink sufficient water and stay hydrated
Massage your head
Take over-the-counter painkillers such as acetaminophen or ibuprofen to help reduce inflammation and relieve symptoms

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Medically Reviewed on 11/17/2022
References

Why Does the Back of My Head Hurt? (https://www.webmd.com/migraines-headaches/why-back-of-head-hurts).

Facial Pain and Headache: (https://emedicine.medscape.com/article/1048596-overview)

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