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 specific headaches, the back of your head may hurt due to one of these 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.

A tension headache isn’t a sign of another medical issue. Still, it can be painful. Some people say that it feels like a vise is squeezing their head.

There are two types of tension headaches:

  • Episodic: It’s often called a stress headache because it comes on when you’re stressed, anxious, hungry, angry, depressed, or tired.
  • Chronic: This kind of headache happens more than 15 times a month for at least 3 months. The pain is almost always there, though it may vary over the course of a day. You may also feel a little bit queasy when you have one.

You can treat most tension headaches with over-the-counter pain relievers such as acetaminophen, ibuprofen, or aspirin. In some cases, your doctor may prescribe an antidepressant, which can also act as a painkiller.

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.

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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.

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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:

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.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on March 20, 2019

Sources

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.”

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