Some headache symptoms occur specifically in the back of the head. Possible causes include tension, migraine, and medication overuse. Some causes can also cause pain in the back of the neck.

This article looks at eight of the most common causes of pain in the back of the head:

  • tension-type headaches
  • migraine
  • medication overuse headaches
  • occipital neuralgia
  • exercise-induced headaches

We also take a look at their symptoms, possible treatments, and prevention methods.

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Tension or tension-type headaches (TTH) usually cause tightness or pressure around the forehead, and may also cause discomfort in the neck, shoulders, or scalp. These headaches can last for up to 7 days, but they can also be brief, lasting for as little as 30 minutes.

The symptoms of a tension-type headache are:

  • a feeling of tightening around the head, which can include the back of the head and may also affect the face or neck
  • pain that is mild to moderate but occasionally severe
  • the headache is not made worse by exercise
  • no nausea or vomiting

Learn more about the causes and treatment of tension headaches.

Migraine headaches are a common type of recurring headache that often start during childhood and increase in frequency and severity with age.

In adulthood, they can occur several times a week, especially in females between the ages of 35 and 45 years.

Common symptoms of migraine include:

  • throbbing intense pain on one side of the head
  • nausea and vomiting
  • visual disturbance
  • heightened sensitivity to light, noise, and smell
  • muscles tenderness and sensitive skin
  • last from a few hours to several days
  • physical activity makes them worse

An “aura” might precede a migraine headache, in which the person experiences flashing lights or other visual disturbances.

Learn more about the triggers and treatment of migraine.

A cervicogenic headache originates in the neck and then travels to the head. It is caused by irritation of the cervical nerves.

The symptoms of a cervicogenic headache include:

  • pain around the eyes and vision problems
  • pain in the neck, shoulders, or arms on one side
  • pain in the head when making certain movements
  • nausea
  • light or noise sensitivity

Occipital neuralgia is a distinctive and less common type of headache that affects the back of the head.

It may relate to damage or irritation of the occipital nerves, which run up the back of the neck to the base of the scalp.

Underlying diseases, neck tension, or other unknown factors might cause the damage or irritation.

The pain in occipital neuralgia can be severe. Other symptoms include:

  • continuous throbbing and burning ache
  • intermittent shocking or shooting pains
  • pain is often on one side of the head and can be triggered by moving the neck
  • tenderness in the scalp
  • sensitivity to light

Due to the similarity of symptoms, a person or medical professional might mistake occipital neuralgia for a migraine headache or another type of headache. A distinguishing feature of occipital neuralgia is pain after applying pressure to the back of the head and scalp.

Exercise-induced headaches occur as a result of strenuous physical activity. They start suddenly during or immediately after exercise, rapidly becoming severe.

A wide range of exercises might trigger this pain, from weightlifting or running to sexual intercourse and straining on the toilet.

Symptoms include pulsating pain on both sides of the head, which can last from 5 minutes to 2 days. These headaches are usually isolated events and may also produce migraine-like symptoms.

Cluster headaches can cause intense pain in one area of the head, mainly around the eyes. The discomfort is usually sudden and sharp, or it may feel like burning. It can last from 15 minutes up to a few hours before disappearing completely.

Cluster headache attacks that happen over a period of time are known as a cluster period and these can last for days, weeks, and even months.

Symptoms also include:

  • restlessness
  • redness and swelling around the painful eye,
  • nasal congestion
  • a blocked nose
  • pale skin
  • facial sweating
  • drooping eyelids
  • face, a smaller

Medication-overuse headaches (MOH) may develop if a person uses too much pain relief medication. MOH headaches are also known as rebound headaches.

Occasional use of pain relief does not cause any problems. However, when a person takes pain relief medication more than 10-15 or more days a month, a medication overuse or rebound headache can occur.

The main symptoms include:

  • persistent, almost daily headaches
  • worse pain when waking
  • a headache after stopping pain relief

Other problems associated with MOH are:

  • sleepiness
  • nausea
  • anxiety
  • irritability
  • lack of energy
  • physical weakness
  • restlessness
  • difficulty concentrating
  • depression

Low-pressure headache, also called positional headache, is a pain in the back of the head caused by intracranial hypotension, which is when the cerebrospinal fluid pressure in the brain reduces to less than 60 millimeters of water (mm H2O).

This headache usually feels worse when sitting or standing, and better when lying down. Bending, coughing, sneezing, lifting, and straining can also trigger it.

Some people may wake up with mild headaches that worsen as the day progresses. The positional nature of these headaches could go away eventually or become weaker with time.

Positional headaches typically affect the back of the head, but may also affect the front area, only one side of it, and even the entire head. The intensity of these headaches is often described as severe, pressure-like, throbbing, pounding, stabbing, and aching.

Any time a person experiences symptoms that are new, different, or unusual, it’s worth seeing a doctor.

But if your headache is severe or starts suddenly, it could indicate a life-threatening condition like meningitis or a stroke.

Other symptoms indicating you should seek emergency medical help include:

  • fever
  • weakness
  • vision loss or double vision
  • confusion

What does a dehydration headache feel like?

A dehydration headache can range from mild to intense, causing pain in the front, back, side, or throughout the head. When a person with this type of headache moves their head, they may feel even more discomfort.

Other dehydration symptoms associated with dehydration headaches include extreme thirst, decreased urination, and dark-colored urine.

Learn more about dehydration headaches.

Does pain in the back of the head indicate a stroke?

A sudden, severe headache, typically affecting the entire head, could indicate stroke. According to the National Institute of Neurological Disorders and Stroke (NINDS), some conditions associated with hemorrhagic stroke can cause a sudden, severe “thunderclap” headache. The pain begins in a split second rather than building gradually.

People may describe a thunderclap headache as the worst headache they have ever experienced. Conditions that may cause this type of pain include subarachnoid hemorrhage, intracerebral hemorrhage, and aneurysm.

How do you relieve a headache in the back of your head?

The treatment for a headache in the back of the head depends on the cause. It can involve both medications and lifestyle changes.

People can try over-the-counter pain relief medications, such as acetaminophen and ibuprofen, to relieve a headache at the back of the head.

NINDS suggests taking time to relax and ease stress, which could include taking a warm bath or trying mindfulness techniques. People may also benefit from avoiding bright lights, drinking water to address dehydration, and massaging the neck and base of the skull.

When should I be concerned about back of head pain?

If someone experiences a sudden, severe headache and stiff neck that may also involve nausea, fever, and vomiting, they should call 911 for help. A severe headache accompanied by confusion, weakness, double vision, or loss of consciousness also requires immediate medical attention.

A person should see a doctor in the following circumstances:

  • They have a headache that worsens over days or weeks.
  • They have two or more headaches per week.
  • A person has a headache following a head injury.
  • A child has a recurring headache.
  • A loss of sensation or weakness accompanies a headache.
  • A person also experiences convulsions or shortness of breath.

Headaches are common. They can affect a person’s quality of life and their ability to carry out everyday tasks.

Many headaches go away without treatment, but some have more serious causes. Anyone who is worried about pain in the back of their head should seek medical advice. If there is an underlying cause that needs addressing, it is better to do so as soon as possible.