What Is That Pain in the Back of Your Head?
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Medically reviewed by Smita Patel, DO
Pain in the back of the head is usually nothing to worry about—other than how it's impacting your day. Pain in the back of the head is commonly caused by different types of headache, like a tension headache, migraine, or exertion headache.
However, in some cases, pain in the back of your head can indicate a more serious type of headache, like a low-pressure or cervicogenic headache. The pain may also be a sign of a condition like occipital neuralgia, which is nerve-related pain.
These headaches and conditions can be treated with medications, lifestyle changes, and in some cases surgeries. Treatment will depend on what exactly is causing the pain in the back of your head.
Tension Headache
Tension headaches are the most common type of headache. They can happen when you are experiencing physical or emotional stress. Tension-type headache can be caused by anxiety, depression, intense physical work, lack of sleep, or missed meals.
Tension headaches cause throbbing pain that feels like a band is squeezing your head. This pain can be felt around different areas of your head, and at times, the pain can concentrate to the back of your head.
Tension headaches can be episodic or chronic. Episodic tension headaches happen 10-15 days a month and can last anywhere from 30 minutes to two days. Pain caused by episodic tension headache usually increases with each headache you experience. Chronic tension headaches happen more than 15 days over a period of three months. The pain felt in chronic tension headaches is more severe.
Migraine
A migraine is a condition that causes chronic and severe headaches. These headaches cause pounding, pulsating, and throbbing pain that usually starts on one side of the head and can make its way toward the back of the head and neck or behind the eyes.
Migraine headaches can last anywhere from 4-72 hours. Other migraine symptoms you might experience include nausea, weakness, and sensitivity to light and sounds.
Around 12% of Americans experience migraines on a regular basis. It's unclear what exactly causes migraine, but research suggests there might be a genetic component.
What triggers migraine varies widely person to person. Some of the major triggers for migraine include:
Stress or anxiety
Bright or flashing lights
Loud noises or strong smells
Sudden changes in weather or environment
Sudden changes in sleeping patterns
Too much physical activity
Tobacco or alcohol
Migraine headaches usually happen in the morning. Some symptoms can linger after a migraine headache goes away. Some post-migraine symptoms include mental exhaustion, neck pain, and feeling that you need much more sleep.
Exertion Headache
Exertion headache, also known as primary exercise headache, is a type of headache that happens during or immediately after exercise or a lot of strenuous physical activity. The headache may also start after fits of coughing or sneezing, as well as after lifting weights or having sex.
According to a 2020 review, exertion headaches might be caused by deficiencies in blood flow control in the head. The deficiencies make it so that your body can't properly regulate rapid blood flow changes that happen during exercise. These quick changes in blood flow alter the pressure in your head, which can cause pain.
People who experience these types of headaches should be evaluated by a healthcare professional as they might be a sign of conditions like heart disease.
Exertion headaches cause pulsing and throbbing pain in the front or back of the head that lasts anywhere from five minutes to 48 hours. Additionally, these headaches are more likely to happen at high altitudes or in hot weather.
Cervicogenic Headache
A cervicogenic headache is a common chronic headache caused by irritation of spinal nerves in the neck. The pain starts out in the neck and usually makes its way to the back of one side of the head.
This type of headache may be caused by an awkward neck movement during physical activity, as well as osteoarthritis or a neck injury. This headache causes a throbbing pain that usually fluctuates between moderate and severe in severity. Pain also increases as you move your neck.
With a cervicogenic headache, pain felt in the back of the head is usually accompanied by the following symptoms:
Reduced range of motion of the neck
Reduced range of motion of the shoulder and arm
Neck stiffness
Sensitivity to light and noise
Shoulder and arm pain
Low-Pressure Headache
A low-pressure headache is caused by leakage of cerebrospinal fluid—the liquid that flows in the brain and spinal cord—through a tear in the spinal cord or brain membrane. This leakage of fluid causes a drop in pressure in the head which causes the pain. A cerebrospinal fluid leak is also known as intracranial hypotension.
A tear that causes cerebrospinal fluid leakage can be caused by connective tissue deficiencies acquired at birth, impact trauma from an accident, or an epidural while undergoing surgery.
A low-pressure headache causes severe aching and throbbing pain in the back of your head. The pain worsens when standing or sitting and improves when lying down for 20-30 minutes. Other low-pressure headache symptoms include:
Sensitivity to light and noise
Vomiting
Increased pain when coughing or sneezing
Impaired hearing
Dizziness
Double vision
Occipital Neuralgia
Occipital neuralgia is a condition in which the nerves in the back of your head are damaged or inflamed. This causes a throbbing or piercing type of pain throughout the back of your head, upper neck, and behind the ears. You may also feel a continuous aching, shooting pain, and burning sensation. The pain is typically described as migraine-like.
Occipital neuralgia is usually caused by pinched nerves, muscle tightness, or a head and neck injury. Occipital neuralgia can also be caused by the following conditions:
Osteoarthritis
Compression of the vertebrae in your neck
Cervical disk disease
Tumors affecting the area
Diabetes
Infection
Occipital neuralgia is a rare condition, with an incidence rate of 3.2 cases per 100,00 people.
Should You Be Concerned About Pain in the Back of Your Head?
Pain in the back of your head usually does not require medical attention. The pain is commonly caused by a tension headache or migraine—conditions that can be treated with home remedies, OTC medications, or lifestyle changes. Sometimes pain in the back of the head can indicate a more serious issue like occipital neuralgia or a low-pressure headache that requires intervention.
You should immediately contact your healthcare provider if you experience pain in the back of your head along with any of the following symptoms:
Fever
Nausea or vomiting
Headache pain followed by confusion, double vision, or a loss of consciousness
A headache that gets worse as the days go on
Severe weakness in any part of the body
Convulsions
Treatment
How your pain in the back of your head is treated depends on what's causing it.
Most headaches can be treated with at-home remedies like resting with your closed eyes in a quiet room, putting a cool towel or cloth on your forehead, staying hydrated, and reducing stress.
Over-the-counter (OTC) or prescription medications can help treat headaches like tension headaches, exertion headaches, and migraine too. Pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen) commonly bring relief. Some natural treatments, like vitamin B2 (riboflavin) or magnesium, may be useful to treat migraine.
Other causes of pain in the back of your head might require different treatment:
Cervicogenic headaches: These can be treated with physical therapy, pain-relief medications, and steroid injections.
Low-pressure headaches: These are treated depending on the severity of symptoms. If symptoms are moderate, treatment involves bed rest, caffeine intake, and OTC pain medications. If symptoms last more than one or two weeks and are severe, low-pressure headaches are treated with an epidural blood patch. This procedure involves injecting a person's blood into the space where the cerebrospinal fluid leak happened so that the leak can be stopped.
Occipital neuralgia: This condition can be treated with medications like muscle relaxants, anticonvulsants, or anti-inflammatories. Non-medication treatments include physical therapy and heat pads. Occipital neuralgia can also be treated by surgery. Surgery to address occipital neuralgia involves stimulating the neck nerves to block pain signaling.
A Quick Review
Pain in the back of your head can be disruptive to your day-to-day routines—sometimes even debilitating. Most causes of pain in the back of the head are types of headaches that can be treated by over-the-counter medications, at-home remedies, and lifestyle changes. These include tension headache, migraine, and exertion headache.
However, in some cases, pain in the back of your head is indicative of more serious headaches or medical conditions, like low-pressure and cervicogenic headaches or occipital neuralgia. If you or a loved one are experiencing symptoms of any of these conditions, reach out to a healthcare provider so you can get relief as soon as possible.
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