Occipital neuralgia can cause pain behind the ears.
A headache behind the ear refers to any pain that originates from that specific area of the head. Though headaches themselves are very common, headaches that occur exclusively behind the ear are fairly unusual.
This type of headache pain can have several causes from nerve injury to dental problems. The cause of the headache behind the ear will determine symptoms and treatment.
This article explores the signs and symptoms of headaches behind the ear and details what causes them. It also discusses how they can be treated to relieve pain and the associated symptoms.
Contents of this article:
There are several possible causes of a headache behind the ear. These include the following:
One of the most common causes of a headache behind the ear is a condition called occipital neuralgia.
Occipital neuralgia occurs when the occipital nerves, or the nerves that run from the top of the spinal cord up through the scalp, are injured or inflamed.
People often mistake sharp pain behind the ear to be the result of a migraine or similar types of headaches, as symptoms can be similar.
People who suffer with occipital neuralgia describe the chronic pain as piercing and throbbing. They also describe it as similar to the feeling of receiving an electric shock in the following places:
- upper neck
- back of the head
- behind the ears
Occipital neuralgia happens as a result of pressure or irritation to the occipital nerves. It typically only appears on one side of the head.
In some cases, the pressure or irritation maybe because of inflammation, overly tight muscles, or an injury. Often, doctors cannot find a cause for occipital neuralgia.
Mastoiditis is an infection of the mastoid bone, which is the bone directly behind the ear.
This infection is much more common in children than adults and generally responds to treatment with no complications.
The temporomandibular joints (TMJ) are the ball and socket joints of the jaw. These joints can become inflamed and painful.
TMJ can cause aching behind the ear and it usually accompanied by jaw pain.
While most people with TMJ inflammation feel the pain in the jaw and behind the ear, others may just experience a headache behind the ear.
TMJ can be caused by:
Symptoms of headaches behind the ear can vary based on the causes.
Occipital neuralgia may cause intense pain to the back of the head and/or upper neck. Often, it can start in the neck and work its way up to the back of the head. The episodic pain is like an electric shock to the back of the head and/or neck.
Signs of an infection, such as fever or tiredness, often accompany mastoiditis.
People experiencing TMJ may sense jaw tightness and pain in addition to a headache behind the ear.
Additional symptoms that people who suffer from headaches behind the ear may experience include:
- pain on one or both sides of the head
- sensitivity to light
- aching, burning, and throbbing pain
- pain behind the eyes
- tender scalp
- pain with neck movement
The main causes of headache behind the ear often overlap. It is crucial to get a proper diagnosis so the condition can be treated appropriately.
For diagnosis, a doctor will ask a person questions about medical history. Information about any recent head, neck, or spine injuries should be included.
After asking questions, a doctor will probably do a physical examination. For this, the doctor will press firmly around the back of the head and base of the skull in an attempt to reproduce the pain through touch. This examination checks for occipital neuralgia, as this condition is sensitive to the touch in most cases.
Some additional steps in diagnosis may include a shot to numb the nerve. If a person experiences relief then occipital neuralgia is likely to be the cause of the pain.
In more atypical cases, a doctor may order an MRI or blood test to further confirm or rule out other causes of the pain.
If occipital neuralgia is ruled out as a possible cause of pain in the initial visit, the doctor will probably check for signs of mastoiditis, including fever and discharge from the ear.
For further diagnosis, a doctor may examine the jaw or recommend a visit to a dentist to check for TMJ.
Treating the pain is the primary method of dealing with a headache behind the ear, unless a root cause can be determined.
There are some at home treatment options for people to try before or in addition to a doctor's care.
A common way to manage headaches at home is to rest or nap in a quiet room.
Some at home treatments include:
- rest in a quiet room
- over-the-counter anti-inflammatory drugs, such as ibuprofen
- massage of neck muscles
- apply heat to back of neck
- reduce stress
- stop teeth grinding
As with any treatment options, a doctor should be consulted before adding medications.
Treatment of headaches behind the ear
When under a doctor's care, someone will have a treatment plan for headaches behind the ear that will include managing the pain and treating underlying causes of the pain.
Depending on the exact cause of headaches behind the ear, a doctor may prescribe medications, including:
- prescription muscle relaxants
- nerve blocks and steroid shots
- physical therapy
- antiseizure drugs, such as carbamazepine and gabapentin
- antibiotics if mastoiditis is suspected
- a night-guard for TMJ
Nerve blocks and steroid shots are often temporary and necessitate repeat visits to the doctor to be reinjected. Furthermore, it may be necessary to administer several shots before the pain is manageable.
In rare cases, an operation may be required. Typically, operations are used if pain does not get better with other treatments or keeps recurring.
Operations may include:
- Microvascular decompression: This procedure involves the doctor finding and repositioning the blood vessels that are compressing the nerves.
- Occipital nerve stimulation: A neurostimulator delivers several electrical pulses to the occipital nerves. In this case, the electric pulses may help block pain messages to the brain.
No matter the treatments decided upon, it is important to relay to a doctor whether or not they are effective.
In some cases, continued pain may indicate that it is the result of another condition, which needs to be treated differently.
Generally, headaches behind the ear are not the result of a life-threatening condition.
In many cases, people experience pain relief when resting and taking medication as prescribed or directed.
In most cases, people with a headache behind the ear should see full or nearly full symptom relief with proper diagnosis and treatment.