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Headache Back of Head – Causes and Treatment
Headaches at the back of the head are a common symptom with many possible causes. Learn about causes, symptoms, diagnosis, and treatment options.
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Headaches at the back of the head are a common symptom with many possible causes. Learn about causes, symptoms, diagnosis, and treatment options.
What are Headaches at the Back of the Head?
Headaches at the back of the head (occipital headaches) refer to pain located in the posterior region of the skull, often near the junction between the head and neck. The pain can feel dull, pressing, throbbing, or stabbing in nature and may vary in intensity. Depending on the underlying cause, the pain can be one-sided or bilateral and may radiate into the neck, shoulders, or temples.
Causes
Headaches at the back of the head can have many different causes. The most common include:
- Tension-type headache: The most frequent type. Muscle tension in the neck and shoulder area causes pressing, band-like pain that often affects the back of the head.
- Occipital neuralgia: Irritation or inflammation of the occipital nerves leads to sharp, shooting pain at the back of the head that can radiate toward the forehead.
- Cervicogenic headache: Pain originating from the cervical spine (neck) that radiates to the back of the head. Common with disc problems or osteoarthritis of the cervical spine.
- Hypertensive headache: High blood pressure can cause throbbing pain at the back of the head, especially in the morning upon waking.
- Migraine: Although migraine typically affects one side of the forehead or temples, it can also be felt at the back of the head.
- Poor posture: Prolonged screen use or an unfavorable sleeping position can cause muscle tension and occipital headaches.
- Stress and psychological strain: Emotional stress frequently leads to muscle tension and resulting headaches at the back of the head.
Symptoms
Symptoms of headaches at the back of the head vary depending on the cause:
- Dull, pressing, or pulling pain at the back of the head
- Sharp, shooting pain (in neuralgia)
- Pain radiating into the neck, shoulders, or temples
- Neck stiffness and restricted range of motion
- Dizziness or nausea (with certain causes)
- Sensitivity to light and noise (with migraine)
- Pain worsening with head movement
When to See a Doctor
In most cases, headaches at the back of the head are harmless. However, certain warning signs require immediate medical attention:
- Sudden, extremely severe headache (so-called thunderclap headache) – may indicate a brain hemorrhage
- Headache combined with neck stiffness, fever, and light sensitivity – possible meningitis
- Headache following a head injury
- Progressively worsening headaches over several weeks
- Headaches accompanied by neurological deficits such as vision disturbances, paralysis, or speech problems
- Headache combined with very high blood pressure
Diagnosis
To diagnose headaches at the back of the head, the doctor begins with a thorough medical history and physical examination. Depending on the suspected cause, further investigations may follow:
- Blood pressure measurement to rule out hypertension
- Neurological examination to assess nerve function
- Imaging procedures such as MRI (magnetic resonance imaging) or CT (computed tomography) of the cervical spine and skull
- Blood tests if an inflammatory condition is suspected
Treatment
Treatment of headaches at the back of the head depends on the underlying cause:
General Measures
- Heat therapy (hot water bottle, warm shower) to relax the neck muscles
- Regular breaks during screen work and ergonomic workplace adjustments
- Stress reduction through relaxation techniques such as yoga, progressive muscle relaxation, or meditation
- Adequate sleep and regular physical activity
Medication
- Pain relievers such as ibuprofen or paracetamol for acute pain
- Muscle relaxants for pronounced muscle tension
- Beta-blockers or antidepressants for prevention of frequently recurring headaches
- Corticosteroid injections or local anesthetics for occipital neuralgia
- Antihypertensive medications for blood-pressure-related headaches
Physiotherapy and Manual Therapy
- Physical therapy to strengthen and stretch the neck and shoulder muscles
- Manual therapy or chiropractic care for cervicogenic headache
- Acupuncture as a complementary treatment method
Prevention
Many cases of headaches at the back of the head can be prevented or reduced in frequency through simple measures:
- Maintaining good posture in daily life and at the workplace
- Regular stretching and loosening exercises for the neck and shoulders
- Staying well-hydrated (at least 1.5 to 2 liters of water daily)
- Stress management and relaxation techniques
- Keeping a headache diary to identify triggers
References
- Stovner LJ et al. - The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. Journal of Headache and Pain, 2022.
- International Headache Society (IHS): The International Classification of Headache Disorders, 3rd edition (ICHD-3). Cephalalgia, 2018.
- World Health Organization (WHO): Headache disorders. Fact Sheet. www.who.int
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