Why Does the Back of My Head Hurt?

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 in people with migraine.

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 may include:

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

Posture

Inadequate posture may also cause pain in the back of your head and neck.

Positioning your body in certain ways may create tension in your back, shoulders, and neck. That tension may cause your muscles to contract and cause a headache.

Headaches that are related to your posture may feel like a dull, throbbing pain at the base of your skull.

Cervicogenic headache

Herniated discs in your cervical spine (neck) can cause pain and tension in this area. This can cause a type of headache called a cervicogenic headache.

The pain associated with cervicogenic headaches typically originates in the back of your head. It typically stays in that area but 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.

Intracranial hypotension can occur spontaneously or as a result following a spinal tap or other procedure in which fluid leaks from the spine.

Intracranial hypertension (high pressure) may also lead to headaches.

Pain in the right side and back of the head

Tension headaches

Tension headaches are the most common cause of pain. These headaches often occur in the back and right side of your head, although it’s also common to feel like a band is encircling the head, causing pain on both sides.

Tension headaches may include a tightness on the neck or scalp. They may feel like a dull, tight constricting pain that isn’t throbbing.

Pain in the back of the head when lying down

Cluster headaches

Cluster headaches are rare but can be 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 and then subside for a while.

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 (watery eyes)
• stuffy nose
• drooping eyelid
• sensitivity to light and sound

Pain in other parts of the head, including the back

Migraine condition

For someone who experiences a migraine condition, headaches can appear in any location. They can be on one side of the head only or switch sides, but some people experience them on the left and back side of the head only.

Migraine conditions can cause:

• severe, throbbing, pulsating pain
• auras (various sensory perceptions)
• 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

Most headaches may be reduced with over-the-counter (OTC) pain relief medications such as acetaminophen (Tylenol). Some medications, like Extra-Strength Tylenol, can help if you have chronic headaches.

Recurrent or persistent headaches often merit a visit to a healthcare professional. Treatment is most effective when it’s based on the exact cause of your headache, and OTC pain relievers shouldn’t be taken long term.

Headaches related to posture

Headaches caused by inadequate posture can be treated immediately with acetaminophen. In the long term, you can treat or try to prevent these headaches by improving your posture. Purchasing an ergonomic work chair with good lumbar support may help, as well as sitting with both feet on the ground.

Headaches caused by herniated discs

Treatment for herniated discs may include physical therapy, gentle stretching, chiropractic adjustments, epidural injections for inflammation, and surgery if needed. Management depends on the cause and severity of the herniated disc.

Occipital neuralgia

Occipital neuralgia may be treated through a combination of ice and heat therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, massage, and prescription muscle relaxers.

In severe cases, a healthcare professional may inject a local anesthetic into the occipital area for immediate relief. This treatment option can last up to 12 weeks.

Tension headaches

Tension headaches are typically treated with OTC pain relievers. A healthcare professional may prescribe medications for severe, chronic tension headaches. They may also prescribe preventive medications like antidepressants or muscle relaxants to reduce the chance of headaches occurring in the future.

Migraine

For migraine, a healthcare professional may prescribe a preventive medication, like a beta-blocker, and an immediate pain-relief medication.

Some OTC medications are designed specifically for treating migraine. These may work for mild migraine attacks, but not severe ones. A healthcare professional may also help you discover what triggers your migraine attacks so that you can avoid these stimuli.

Cluster headaches

Treatment for cluster headaches focuses on shortening the headache period, reducing the severity of attacks, and preventing further episodes.

Short-term treatment may include:

• triptans, which are also used to treat migraine and can be injected for fast relief
• anti-inflammatory medications, like steroids
• local anesthetic injection
• preventive medications such as topiramate, verapamil, lithium, and galcanezumab

Preventive methods may include:

• calcium channel blockers
• melatonin
• nerve blockers

Consider making an appointment with a healthcare professional if:

• you experience headaches that last for more than a few days at a time
• your headaches interfere with your usual activities
• the pain is accompanied by tenderness near your temple
• you notice any 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, prompt medical care is advised.

If you experience headaches alongside any of the following symptoms, emergency medical attention is essential:

• sudden changes in your personality, including uncharacteristic shifts in mood or agitation
• fever, stiff neck, confusion, and decreased alertness to the point where you cannot 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 abruptly, especially if they’ve woken you up

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

Headaches in the back of your head may be due to different conditions and lifestyle habits. Often, headaches may be experienced in more than one location.

If the pain in your head is interfering with your typical routine, medical care is highly advised. Other reasons to seek care may include a headache that doesn’t subside after a few hours or gets worse, manifests with symptoms like fever and disorientation, and is accompanied by pain in other parts of the body and numbing sensations.