What does a headache in the back of the head mean?

If you have pain anywhere in your head, your first question is likely, “How do I make it stop?” Headaches can be uncomfortable and make it difficult to function at your best. To get relief, you’ll need to figure out why your head hurts in that particular spot—and what’s causing the throbbing. And if the pain is in the back of your head, you may worry it’s cause for concern. 

The most common type of back-of-head headaches are tension headaches, but there are other possible culprits. Most of the time, headaches in the back of the head aren’t dangerous, but if they are chronic or accompanied by other concerning symptoms, you may need medical advice. 

Here, we’ll take a closer look at what causes headaches in the back of your head and what to do about them.

What does a headache in the back of the head mean?

There are many different types of headaches that can cause pain and pressure in the back of the head. While it can help guide you to an answer on what’s causing the issue, the location of the pain shouldn’t be cause for alarm.

“The location of a headache can sometimes provide clues to the underlying cause,” explains Sean Ormond, MD, an anesthesiologist and interventional pain management physician at Atlas Pain Specialists in Arizona. “However, it is important to remember that headaches can occur in a variety of locations, and the location alone is not always enough to diagnose a specific condition.” 

Many people worry that a headache in the back of the head or in another specific location may indicate something serious, such as a stroke or aneurysm—but these are typically accompanied by other symptoms. 

“If you have a headache that is severe, persistent, or accompanied by other symptoms, such as fever, neck stiffness, or vision changes, it is important to see a doctor,” Dr. Ormond says.

More likely, your back-of-the-head headache is caused by one of the following eight headache types. Here, we’ll take a closer look at these headache types, including how common they are, typical symptoms, what causes them, and how long they usually last.

Tension headache

Overall, tension-type headaches are the most common type of headache affecting adults, according to the Cleveland Clinic. A tension headache is a primary headache that occurs without an underlying cause. 

“They are thought to be caused by muscle tension in the scalp and neck,” says Raj Dasgupta, MD, a quadruple-board certified physician. “Tension headaches can be triggered by stress, anxiety, poor posture, or lack of sleep.” Symptoms of a tension headache include a throbbing sensation, and feeling like you have a vice or band around your head. Tension-type headaches tend to be most painful in the back of the head, shoulders, and temples. They can last anywhere from 30 minutes to up to a week.

Migraine headache

Migraine headaches affect about 10% of the population. These types of headaches can last between four and 72 hours. What distinguishes migraines from other types of headaches is that they tend to be a full-body experience: head pain and pressure are usually one of several symptoms. Common migraine symptoms include sensitivity to light and sound, nausea, vomiting, and an aura, which usually affects your vision, causing flashing lights, zigzagged lines, and vision loss. People who experience auras also may have numbness and a tingling feeling in the face.

RELATED: Types of migraine headaches | Migraine treatment

Cervicogenic headache

Cervicogenic headaches are not a very common type of headache: They are brought on by neck problems like arthritis, muscle strain, or a herniated disc and affect between 0.4%-4% of people who have headaches. 

“They typically manifest as a dull ache at the back and side of the head, and they can also cause pain in the neck, shoulders, and arms,” Dr. Ormond says.

Cervicogenic headaches are a chronic condition and will only resolve once you fix the underlying neck issue that’s causing the headache.

Poor postural alignment

One often overlooked cause of headaches in the back of the head is poor posture. Symptoms caused by poor postural alignment may include muscle tension in the neck, shoulders, and upper back, in addition to tension in the back of your head. These types of headaches are usually relieved once the trigger is tackled, such as correcting chronic poor posture and doing exercises to release muscle tension.                      

Medication overuse headaches

Sometimes the headache medications you are taking—especially when taken frequently for months—can induce headache symptoms, including pain or pressure in the back of your head. “Over-the-counter pain relievers and caffeine are just two examples of medications that can cause headaches if taken too frequently or in high doses,” Dr. Ormand explains.

Medication overuse headaches, also known as rebound headaches, affect between 0.5%-2.6% of people. Symptoms are similar to tension headache or migraine symptoms, though they may be stronger and occur more often. Medication overuse headaches resolve once you decrease your medication intake, though you should consult with a healthcare provider for advice about the best way to do this. 

Sinus headaches

If your back of head headache has happened soon after a respiratory infection, you might be dealing with a headache caused by sinus pressure. “Headaches at the back of the head, as well as facial pain and pressure, can be brought on by sinus problems, such as sinusitis,” Dr. Ormond explains.

Symptoms may resemble those of a migraine, and research has found that most headaches that are thought to be sinus headaches are actually migraines. However, you can distinguish between migraine or a sinus headache by noting whether or not you’ve recently had a cold or other virus, and how long your symptoms last. Untreated sinus infections usually last longer than migraines.

Dehydration headache

If you are dehydrated because of a recent illness, staying in the heat for too long, or forgetting to drink enough water, you may develop a dehydration headache. A dehydration headache is a secondary headache, which is a symptom of an underlying cause or condition. Symptoms of this type of headache may include pain or pressure in the back of the head, according to the Cleveland Clinic. Other symptoms may include a dry mouth, feeling very thirsty, and dizziness. Headache pain subsides once you hydrate and rest.

Occipital neuralgia

Though considered a rare type of neurological condition, occipital neuroglia is a possible cause of headaches in the back of the head, scalp, and neck, says Dr. Ormond. “Damage or irritation to the occipital nerves, which run from the upper neck to the back of the scalp, is the root cause,” he explains. Pain from occipital neuralgia may be sharp, pulsating, shooting, or burning, and it can be brought on by neck movements or changes in head position, Dr. Ormond notes. “Occipital neuralgia can be a very painful condition that makes it difficult to sleep, work, or enjoy everyday activities,” he says.

How to relieve a headache in the back of the head

The treatment options available to relieve a headache in the back of the head depend on which type of headache or health condition is causing the headache.

Medications

You can get temporary pain relief from most types of headaches with over-the-counter medications. Certain types of headache disorders are treated with different prescription medications.

• Over-the-counter medications: Ibuprofen, acetaminophen, or another anti-inflammatory are good over-the-counter choices, says Dr. Ormond.
• Prescription medications: 
  • Severe headaches or migraine often require triptans or ergot alkaloids.
  • Occipital neuralgia treatment may include anticonvulsants, antidepressants, or injections of cortisone or botulinum toxin (Botox).
  • Cervicogenic treatments may be treated with muscle relaxants, cortisone injections, or anesthetic injections.

If you have a headache caused by medication overuse, you should gradually taper off using the medication under the care of your healthcare provider. 

Physical therapy

Physical therapy may be helpful for migraine, tension, and cervicogenic headaches, according to research. Visit a physical therapist for a personalized exercise plan that can alleviate the type of headache you’re experiencing. 

Acupressure

Sometimes headache pain can be relieved by acupressure, according to the Memorial Sloan Kettering Cancer Center. Pressing on certain acupoints in the body increases the flow of blood and causes muscles to relax. In particular, a pressure point called LI-4 can help with headache symptoms. This is stimulated by gentle pressing on the area between your thumb and forefinger. Just be sure to visit a licensed acupuncturist who has completed an accredited training or Master’s program.

Lifestyle changes

Lifestyle changes may also be helpful to relieve and treat headache symptoms in the back of the head. Dr. Ormond suggests:

• Making sure to get enough sleep, which can help with stress management and muscle tension
• Using ice to relieve pain and reduce inflammation; you can apply an ice pack to the back of your head
• Using a heating pad on the back of your head to relax your muscles and reduce pain
• Destressing with yoga, meditation, or other relaxation techniques to reduce muscle tension and pain

When to see a healthcare provider

Most of the time, headache pain in the back of your head is not something to be worried about. Still, there are some circumstances where a headache in the back of your head could indicate a more serious condition.

If you’re experiencing sudden, severe pain that is the worst you’ve ever experienced, seek urgent medical care or visit the emergency room. You should also seek immediate care if your headache is accompanied by fever, stiff neck, a rash, or overall weakness. 

Schedule an appointment with your primary care healthcare provider or neurologist if your headaches have changed, are not relieved by over-the-counter pain medication, or if they are interfering with your daily life. “In general, it’s always a good idea to see a doctor if you’re concerned about a headache,” Dr. Dasgupta says.