Why Does the Back of My Head Hurt?

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

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

Pain in the neck and back of the head

Occipital neuralgia

Occipital neuralgia is a condition that occurs when the nerves that run from your spinal cord to your scalp are inflamed. It’s often present for people with a migraine condition. Occipital neuralgia is a condition that causes sharp, aching, throbbing pain that starts at the base of the head in your neck and moves toward your scalp.

Other symptoms include:

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

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. That tension may cause a headache. You may feel a dull, throbbing pain at the base of your skull.

Cervicogenic headache

Herniated discs in your 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 your head. It may also be felt in your 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.

Low-pressure headache

Low-pressure headache is caused by low spinal fluid pressure in the brain. This occurs when spinal fluid leaks from the spine. This is also often called intracranial hypotension. These can occur spontaneously or as a result following a spinal tap or other procedure in which fluid leaks from the spine, resulting in the headache.

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 your head. They may include a tightness of the neck or scalp. They feel like a dull, tight constricting pain that isn’t throbbing.

Pain in the left side and back of the head

Migraine condition

For someone who experiences a migraine condition, the headache caused by migraine can appear in any location. They can be unilateral or side switching, but many people experience them on the left side of the head or the back of the head.

Migraine conditions 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.

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 headache symptoms

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

The symptoms of many headaches can be reduced with over-the-counter pain relief medications such as 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 discs

Headaches caused by herniated discs rely on the treatment of the underlying condition. Treatment for herniated discs include physical therapy, gentle stretching, 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, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, massage, and prescription muscle relaxers. In severe cases, a 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. A doctor may prescribe prescription medications for severe, chronic tension headaches. A doctor may also prescribe preventive medications like antidepressants or muscle relaxants to reduce headaches from occurring in the future.

Treating migraine

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

Some over-the-counter medications are designed specifically for treating migraine condition. These may work for mild migraine attacks, but not severe ones. A doctor may also help you discover what triggers your migraine condition 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.

Short-term treatment may include:

• triptans, which are also used to treat migraine condition and can be injected for fast relief
• steroids
• local anesthetic injection
• treatment with drugs such as topiramate, verpamil, lithium, and galcanezumab

Preventive methods may include:

• corticosteroids
• calcium channel blockers
• melatonin
• nerve blockers

In extremely severe cases, surgery may be used.

Make an appointment with a healthcare professional 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 your 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, get emergency medical attention:

• sudden changes in your personality, including uncharacteristic changes in mood 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

If you need help finding a primary care doctor, then check out our FindCare tool here.