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Pain in the Back of the Head

Overview

Headaches can range from annoying to disruptive in severity. They can appear in any location on the head.

Headaches that involve pain in the back of the head can have a number of different causes. Many of these causes can be identified by additional symptoms. These symptoms include the type of pain experienced, and other locations where the pain may be present.

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Causes

What causes pain in the back of the head?

There are a number of different causes that can lead to headaches occurring in the back of the head. In many cases, these headaches also cause pain in other locations, or are triggered by certain events.

The types of pain, location, and other symptoms you’re feeling can help your doctor diagnose what’s causing your headache and how to treat it.

Pain in the neck and back of the head

Arthritis

Arthritis headaches are caused by inflammation and swelling in the neck area. They often cause pain in the back of the head and neck. Movement typically triggers more intense pain. These headaches can be caused by any kind of arthritis. The most common are rheumatoid arthritis and osteoarthritis.

Learn more about arthritis.

Poor posture

Poor posture can also cause pain in the back of your head and neck. Poor body positioning creates tension in your back, shoulders, and neck. And that tension may cause a headache. You may feel a dull, throbbing pain at the base of your skull.

Herniated disks

Herniated disks in the cervical spine (neck) can cause neck pain and tension. This can cause a type of headache called a cervicogenic headache.

The pain typically originates and is felt in the back of the head. It may also be felt in the temples or behind the eyes. Other symptoms may include discomfort in the shoulders or upper arms.

Cervicogenic headaches may intensify when you’re lying down. Some people will actually wake up because the pain disrupts their sleep. When lying down, you may also feel a pressure on the top of your head like a weight.

Learn more about herniated disks.

Occipital neuralgia

Occipital neuralgia is a condition that occurs when the nerves that run from the spinal cord to the scalp are damaged. It is often confused with migraines. Occipital neuralgia causes sharp, aching, throbbing pain that starts at the base of the head in the neck and moves towards the scalp.

Other symptoms include:

  • pain behind the eyes
  • a sharp stabbing sensation that feels like an electric shock in the neck and back of the head
  • sensitivity to light
  • tender scalp
  • pain when moving your neck

Learn more about occipital neuralgia.

Pain in the right side and back of the head

Tension headaches

Tension headaches are the most common cause of pain. These headaches occur in the back and right side of the head. They may include a tightness of the neck or scalp. They feel like a dull, tight constricting pain that isn’t throbbing.

Learn more about tension headaches.

Pain in the left side and back of the head

Migraines

Migraines can appear in any location, but many people experience them on the left side of the head or the back of the head.

Migraines can cause:

  • severe, throbbing, pulsating pain
  • auras
  • nausea
  • vomiting
  • watering eyes
  • light or sound sensitivity

Migraine headaches may start on the left side of the head, and then move around the temple to the back of the head.

Learn more about migraines.

Pain in the back of the head when lying down

Cluster headaches

Cluster headaches are rare but extremely painful. They get their name from the “cluster periods” in which they occur. People with cluster headaches experience frequent attacks. These periods or patterns of attack may last weeks or months.

Cluster headaches may cause pain in the back of the head or the sides of the head. They may get worse when lying down. Other symptoms to watch for include:

  • sharp, penetrating, burning pain
  • restlessness
  • nausea
  • excessive tearing
  • stuffy nose
  • drooping eyelid
  • sensitivity to light and sound
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Treatment

How is pain in the back of the head treated?

The symptoms of many headaches can be reduced with over-the-counter pain relief medications like acetaminophen (Tylenol). Some medications, like Extra-Strength Tylenol, can help if you have chronic headaches.

Treatment is most effective when it’s based on the exact cause of your headache.

Treating arthritis headaches

Arthritis headaches are best treated with anti-inflammatories and heat to reduce inflammation.

Treating headaches caused by poor posture

Headaches caused by poor posture can be treated immediately with acetaminophen. In the long term, you can treat or try to prevent these headaches by improving your posture. Purchase an ergonomic work chair with good lumbar support, and sit with both feet on the ground.

Treating headaches caused by herniated disks

Headaches caused by herniated disks rely on the treatment of the underlying condition. Treatment for herniated disks include physical therapy, gentle stretching, chiropractic manipulation, epidural injections for inflammation, and surgery if needed. Good results may be maintained through exercise.

Treating occipital neuralgia

Occipital neuralgia may be treated through a combination of warm/heat therapy, non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, massage, and prescription muscle relaxers. In severe cases, your doctor may inject a local anesthetic into the occipital area for immediate relief. This treatment option can last up to 12 weeks.

Treating tension headaches

Tension headaches are typically treated with over-the-counter pain relievers. Your doctor may prescribe prescription medications for severe, chronic tension headaches. Your doctor may also prescribe preventative medications like antidepressants or muscle relaxants to reduce headaches from occurring in the future.

Treating migraines

For migraines, your doctor may prescribe both a preventative medication, like a beta-blocker, and an immediate pain-relief medication.

Some over-the-counter medications, like Excedrin Migraine, are designed specifically for migraines. These may work for mild migraines, but not severe ones. Your doctor may also help you discover what triggers your migraines so that you can avoid these stimuli.

Treating cluster headaches

Treatment for cluster headaches focuses on shortening the headache period, reducing the severity of attacks, and preventing further attacks from occurring.

Acute treatment may include:

  • triptans, which are also used to treat migraines and can be injected for fast relief
  • octreotide, an injectable artificial version of the brain hormone, somatostatin
  • local anesthetics

Preventative methods may include:

  • corticosteroids
  • calcium channel blockers
  • melatonin
  • nerve blockers

In extremely severe cases, surgery may be used.

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When to see a doctor

When to see a doctor

Make an appointment with your doctor if:

  • you start experiencing new headaches that last for more than a few days
  • your headaches interfere with your normal activities
  • the pain is accompanied by tenderness near the temple
  • you experience any new changes in headache patterns

If you develop a severe headache that’s worse than you’ve ever had, or if your headaches become progressively worse, you should make an appointment as soon as possible.

If your pain becomes impossible to think through, go to an emergency room.

There are some symptoms that indicate an emergency. If you experience headaches alongside any of the following symptoms, seek emergency medical attention:

  • sudden changes in your personality, including uncharacteristic mood swings or agitation
  • fever, stiff neck, confusion, and decreased alertness to the point where you’re struggling to focus on a conversation
  • visual disturbances, slurred speech, weakness (including weakness on one side of the face), and numbness anywhere in the body
  • severe headaches following a blow to the head
  • headaches that come on extremely abruptly when they normally don’t, especially if they’ve woken you up
Article resources
  • Clauw D. (n.d.). Osteoarthritis and headaches.
  • The complete headache chart. (2008).
  • Headache: When to worry, what to do. (2017).
  • Mayo Clinic Staff. (2017). Cluster headache.
  • Mayo Clinic Staff. (2017). Migraine.
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