Pain in the Back of Your Head
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.
Causes of Headaches in the Back of Your Head
Tension headache
This is the most common type of headache. It happens when you tense the muscles in your scalp, face, jaw, and neck because of mental or emotional stress. You will usually feel pain on both sides of your head and you may also:
- Have mild to moderate pain
- Feel constant pressure in the front of your face or your head or neck
- Feel like a belt is being tightened around your head
- Feel sensitive to light and sound
It can be caused by:
- Clenching your jaw
- Working intensely
- Missing meals
- Depression
- Anxiety
- Not getting enough sleep
There are two forms of tension-type headache: episodic and chronic.
Episodic tension type headaches. You may get these between 10-15 days a month. Each headache may last from 30 minutes to several days. Your headache pain may also increase as you get more frequent headaches.
Chronic tension-type headaches. This tends to be more serious or disabling than episodic headaches. You may get these more than 15 days a month. Your pain may be constant over days or months. They may also make your scalp so sore that brushing your hair is painful. You will likely have episodic tension-headaches before you develop chronic headaches.
Treatment for tension-type headaches includes:
- Medicines such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants, triptans (medicines used to treat migraines and cluster headaches), barbiturates, or ergot derivatives
- For people with specific disorders underlying their headache, treatment may start by treating the suspected disorder. Such as anti-inflammatory medicine or corrective devices for people with temporomandibular joint dysfunction (TMJ) or a sleep study for people with sleep apnea.
- Alternative therapies, such as biofeedback, relaxation training, meditation, cognitive behavioral therapy, physical therapy, and massage.
- Home care, such as a hot shower, application of moist heat to the back of your head and neck, and gentle neck exercise and stretching.
Poor posture
Poor posture when you sit, work, drive, and sleep can cause tension-type headaches by putting stress on your shoulders and neck. This may tighten the muscles at the back of your head. For instance, you may get a headache by holding your chin down while reading or holding a phone between your shoulder and ear.
Be aware of how you're sitting or standing and notice if you feel any strain in your shoulders or neck. Make changes to your posture to help relieve your tension. For instance, change your workplace or car seating so you don't strain your shoulders and neck while working and driving. Make sure your bed and pillows provide good support for the way you sleep. Learn and practice good posture for sitting and standing. Over-the-counter pain relievers (like acetaminophen or ibuprofen) may help in the short term. In some cases, you may need physical therapy to improve your posture. Ask your doctor for a referral.
Arthritis headache
Degenerative arthritis and TMJ can also cause tension-type headaches. 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 they can treat these headaches with anti-inflammatory drugs, muscle relaxers, or both.
Low pressure headache
This type of headache is caused by low pressure in your cerebrospinal fluid due to a small leak. Your spinal fluid fills the bag of liquid (meninges) that cushions and supports your brain. If you have a small leak in your meninges, your brain may sag downward when you're upright. This stretches the nerves in the lining around your brain and causes pain.
Symptoms usually include a headache in the back of your head that may be intense when you sit or stand up and get better when you lie flat. You may notice that your headache starts or gets worse shortly after you get out of bed. You may also have a stiff, sore neck, nausea, and vomiting.
In most cases, your doctor will suspect a low pressure headache if you have had a spinal tap, surgery on your spine, or trauma to your head and neck. Sometimes, though, it may be caused by a sneeze you stifled, a violent cough, or some other injury you didn't know you had. You may also be more prone to spinal fluid leaks if you have hyperflexibility of the joints because your meninges may be more stretchy than other people's.
See your doctor if you think you have a low pressure headache. They likely will use a series of tests and imaging studies to diagnose you.
The first treatment you try will usually include a period of bed rest, increased fluid intake, and caffeine. This should help heal the hole from which your spinal fluid is leaking. If that doesn't work, your doctor may try an outpatient procedure called an epidural blood patch. For this procedure, your doctor draws blood from your arm and injects it into a safe location on your lower back. This usually heals the hole very quickly, although they may need to repeat the procedure. If this doesn't work, an interventional radiologist can sometimes plug the hole using an X-ray to find the exact location of the leak.
Occipital neuralgia
This rare type of headache involves pain in your occipital nerves. You have one on each side of your head that runs from your spinal cord to your scalp. If one of your occipital nerves is irritated, you may have pain on in your scalp that may is shooting, zapping, electric, or tingling. Your scalp may be so painful that you have trouble washing your hair or lying on a pillow. Or your scalp may be numb and you could have pain that shoots toward one of your eyes. The pain is usually on one side of your head.
Causes include:
- A pinched nerve in your neck due to arthritis or a previous injury or surgery to your scalp or skull
- Tight muscles that put pressure on the nerves at the back of your head
- In some cases, your doctor may not know why you get it.
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 your attacks.
Cervicogenic headache
This is a rare cause of headache in the back of your head, but it can be long-term (chronic) and happen repeatedly (recurrent). You may feel pain in your head or face even though the source of your pain is in your neck. This is called referred pain because you feel the pain in one part of your body when it’s really coming from somewhere else.
The pain usually starts after you move your neck and happens on one side of your head. You may have reduced range of motion in your neck or your headache may get worse if you move your neck in a certain way or put pressure on the back of your neck. The pain may also radiate from your neck or the back of your head to the front of your head or behind your eye. The pain may be very similar to that of a migraine or tension headache.
These are secondary headaches, which means they're caused by another medical issue. This type of headache usually means your have a disorder in the bones, disks, or soft tissues in your neck. Such disorders of your cervical (upper neck) spine may include:
- Tumors
- Broken bones
- Infections
- Rheumatoid arthritis
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.
Migraine
Migraines are usually recurrent, moderate-to-severe, throbbing headaches on one side of your head. It's caused by the activation of nerve fibers in the blood vessels in your meninges (the sack of fluid that cushions and supports your brain). Untreated, migraines usually last between 4 and 72 hours. You may also have:
- Sensitivity to light, noise, and smells
- Nausea
- Vomiting
Migraines happen most often first thing after you wake up. And some people also have regular migraines right before their period or on the weekend after a stressful week of work. You may not have any symptoms between headaches, but many people feel extremely tired or weak immediately after their migraine. Many different factors can trigger a migraine, and these can vary between people. Some known triggers include:
- A sudden change in the weather or your environment
- Sleeping too much or not enough
- Strong smells
- Low blood sugar
- Bright or flashing lights
- Eating something that was prepared with monosodium glutamate (MSG)
- Wine and other types of alcohol
- Fermented or pickled foods
- Aged cheese
- Cured or processed meats
Your doctor may suggest you try:
- Medicines such as triptans, ergot derivative drugs, and OTC pain medicine
- Small amounts of caffeine, which can help relieve your symptoms when you first start having them
- Staying hydrated, especially if you have vomiting during your headache
- Putting a cool cloth or icepack on your forehead
- Napping or resting with your eyes closed in a quiet, dark room
Exertion headache
These types of headaches come on immediately after or even while you're doing a physical activity. For that reason they may be called "exercise headaches" or "weightlifter's headaches." Experts think they may be caused when your veins and arteries expand to give you more blood and oxygen when you exert yourself. When blood vessels in your head expand, it can cause pressure in your head that triggers the pain. They can last between 5 minutes and 48 hours. Symptoms may include:
- Neck pain
- Pain can be on one or both sides of your head
- Pulsating on throbbing pain
- Severe pain that you may describe as the worst headache of your life
- Blind spots or other visual disturbances
- Nausea and vomiting
- Sensitivity to light
Activities that may trigger an exertional headache include:
- Coughing or sneezing
- Running or doing aerobics
- Weightlifting
- Straining to go to the bathroom
- Having sex
You may get relief from your headache using:
- NSAIDs, such as ibuprofen or naproxen, that you can get over the counter
- Prescription NSAIDs, such as indomethacin, for short-term treatment
- Beta-blockers, such as nadolol or propanolol, for long-term treatment
If you know what triggers your headache, try avoiding that activity. If that isn't possible, try the following to help prevent a headache:
- Warm up and cool down and ramp up intensity slowly.
- Avoid exercising in extreme temperatures (whether too hot or too cold).
- Don't work out if you're not acclimated to that altitude.
- Stay hydrated.
- Get plenty of rest.
- Mix up your routine to see if something else also triggers a headache.
- Wear sunglasses if it's bright and moisture-wicking clothes when it's hot.
- Eat a healthy diet, and avoid preservatives and processed foods.
Cluster headache
This is one of the most severe types of headache. It causes sudden, extremely painful headaches at the same time of day or night for several weeks. They usually happen on one side of your head, often behind or around one of your eyes. The pain usually grows in intensity for 5-10 minutes and lasts for up to 3 hours. Your nose and eye on the same side as your headache may get red, swollen, and runny. Some people also feel restless, agitated, or sensitive to light, sound, or smell. Some people also have changes in their heart rate and blood pressure. You may have a migraine-like aura and nausea before you get one.
These often happen more often at night than during the day, and the pain may be so bad it wakes you up from sleep. Many people have 1-3 headaches a day a couple of times of year, usually spring and fall. Some people may mistake them for allergy symptoms.
Triggers include alcohol (especially red wine), tobacco smoke, and previous head trauma.
Treatment options include:
- Vagus nerve stimulation
- Medications, including triptans, calcium-channel blockers, anticonvulsants, or antipsychotics
- Galcanezumab injections
- Electrical stimulation or surgical procedures on your occipital or trigeminal nerves
When to See a Doctor for a Headache in the Back of Head
Most headaches aren't serious, but they may be a symptom of a medical condition. Go see your doctor if you have a headache and you also have:
- Fever above 103 F that won't go away
- Headaches that feel different or happen more often than usual, especially if you're 50 or older
- A headache that happens only when you lie flat or only when you stand up
- Pain or tenderness in your jaw or in your temple when you chew or apply pressure
- A stiff neck
- Cancer or an autoimmune condition and have more headaches or more severe headaches
- Numbness or weakness
Go to the ER if you have:
- A sudden severe headache that gets worse
- Confused thoughts or slurred speech
- Changes in your ability to see or speak
- Weakness, drowsiness, confusion, or loss of balance
- Shortness of breath
Takeaways
Many things can cause a headache in the back of your head, including stress, poor posture, or medical conditions. Headaches are rarely serious and you have a lot of options for treating your headache, such as ibuprofen or naproxen. But if you are running a fever, have a stiff neck, or if your headaches are getting worse or more frequent, you should see your doctor as soon as possible.
Headache in the Back of Your Head FAQs
How do I get rid of pain in the back of my head?
This depends a lot on the cause of the headache in the back of your head. Your doctor will likely suggest you try an NSAID, like ibuprofen or naproxen, in the short term. Over the long term, your doctor will want treat the cause of your headache. You may need other treatments to get rid of your headaches, such as triptan drugs (for migraine, cluster, or tension headaches), physical therapy (for poor posture), or a surgical procedure (for low pressure or cervicogenic headaches).
