What Causes Headaches at the Back of the Head?

There are a number of different causes that can lead to headaches that cause pain in the base of the skull. Below are a few types of these headaches:

Tension headaches

• Tension headaches are the most common cause of pain in the back of the head. They can last for 30 minutes to 7 days.
• Severe stress, fatigue, lack of sleep, skipping meals, poor body posture, or not drinking enough water may cause these types of headaches.
• Patients usually feel tightening around the back or front of the head; pain may range from dull to severe.
• Treatment includes painkillers, lifestyle modifications, massage, and sometimes relaxing techniques (e.g., meditation). However, frequent tension headaches need a doctor’s supervision for further treatment.

Migraine

• Migraine is a common type of recurring headache that often starts during childhood and increases in frequency with age.
• It is most commonly seen in females.
• Symptoms include severe pain on one side of the head with nausea, vomiting, and visual disturbance. Patients are usually sensitive to light, noise, or smell. Physical activity can make the pain worse. Pain may last for a few hours to several days.
• Causes usually include emotional or physical stress, environmental factors, and dietary changes. Sometimes medications (e.g., contraceptive pills) can induce migraine headaches.
• Treatment of migraine includes painkillers and resting in a darkened room. Lifestyle modifications, hormonal therapy, and anti-migraine drugs such as triptans are usually recommended by doctors to reduce the frequency and intensity of migraines.

Medication overuse or rebound headache

• Medication overuse headaches (MOH) may develop if a person uses too many painkillers.
• Symptoms include persistent headaches with severe pain. Usually, headaches restart after stopping painkillers. Other symptoms include anxiety, irritability, tiredness, restlessness, concentrating difficulty, memory loss, and sometimes even depression.
• The best treatment is often to stop taking the painkiller entirely. Headaches become worse at first but will quickly resolve. In more severe cases, people should see a doctor. An individual may need physical or behavioral therapy to break the habit of using pain relievers.

Occipital neuralgia

• Occipital neuralgia is a rare but severe headache that tends to begin at the base of the neck and spreads up to the head, then behind the ears.
• Usually occurs when there is 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 nerve damage or irritation.
• Pain is usually severe with a burning or shooting sensation; the pain remains on one side but often worsens with neck movement. The patient would usually be sensitive to light.
• Possible causes of occipital neuralgia include damage to the spinal cord, tumors, nerve damage caused by diabetes, swelling of blood vessels, and rarely infection.
• Treatment options include applying heat packs, resting, massage, physical therapy, and taking painkillers, which can reduce swelling and inflammation. Severe pain may require drugs, such as oral muscle relaxants, nerve block injections, steroid injections, or local anesthesia. On rare occasions, surgery for occipital neuralgia may be necessary to reduce pressure on the nerves or block pain impulses to this part of the body.

Exercise-induced headaches

• Exercise-induced headaches occur as a result of stressed physical activity. Pain may start immediately after exercise.
• Symptoms include a heartbeat-like pain on both sides of the head, which can last from five minutes to two days. These headaches are usually isolated events and may also produce migraine-like symptoms.
• Causes include weightlifting, running, and sometimes sexual intercourse, or straining on the toilet.
• Treatment includes taking painkillers before exercise, avoiding stressful activities, eating and drinking healthy foods, and getting sufficient sleep.

Headaches in the back of your head are typically tension headaches, which are very common and typically not a sign of serious illness. Many factors can cause you to get headaches in this area, and you may be able to prevent them by avoiding certain triggers. Common headache triggers include:

• Physical stress
• Emotional stress
• Alcohol or caffeine
• Dehydration
• Skipping meals
• Changes in sleep patterns
• Excessive painkiller use
• Poor posture
• Illness
• Genetics
• Environment

Headaches can be usually treated at home; however, secondary headaches and headaches causing severe symptoms should be evaluated by health professionals to rule out underlying causes.  

If the headache pain you are experiencing is sudden, severe, or accompanied by the symptoms below, consult your doctor to evaluate what could be causing headaches in this area:

• Confusion
• Memory loss
• Loss of balance
• Vision changes
• Slurred speech
• Neck pain or stiff neck
• Seizures

There are more than 150 types of headaches, either primary like migraines, or secondary as a symptom of illnesses.

The International Headache Society lists more than 150 types of headaches, and based on it headaches are classified into three main categories which include:

Primary headaches

A headache with no clear underlying cause is called a primary headache. It may be due to overactivity or strain. Primary headaches might not be life-threatening but may affect the quality of life. Below are a few common types of primary headaches:

• Tension headaches: These occur when the muscles of the face or the scalp become tense. This may be due to physical or mental stress.
• Migraine headaches: Migraine pain is moderate to severe and can last from four hours to three days. Multiple factors cause migraines, and they may have a hormonal origin. Migraine symptoms include sensitivity to light, noise, or smell.
• Cluster headaches: This headache type is rare but is the most severe type of primary headache. The pain is severe, throbbing, and mostly localized to behind the eye. It may be accompanied by watery eyes and sensitivity to light.

Secondary headaches

Headaches due to an underlying medical condition are called secondary headaches. This includes infection, severe injury, tumors, bleeding in the brain, and sometimes, even life-threatening causes. Below are a few common types of secondary headaches:

• Sinus headaches: Sinus headaches are associated with infection of the sinuses. This pain is associated with a deep and constant throbbing in the cheekbones, forehead, or bridge of your nose. The pain usually gets worse with sudden head movement or straining.
• Medication overuse headaches: These occur due to taking over-the-counter painkillers too frequently. This is among the most common type of severe headaches seen in hospitals and is also called “transformed” headaches. It is believed that 4% of the population worldwide has chronic daily headaches of some type — a significant subset of which are due to medication overuse.

Other headaches

Any other headaches, facial pain, and pain involving the 12 cranial nerves (nerves supplying from the brain to other parts of the body) are classified in this group.

• Trigeminal neuralgia (TN): This is the most common cause of facial pain; pain is so severe that it affects the daily life of the patient leading them to depression.

Below are a few common ways to get rid of headaches:

• Get plenty of rest
• Drink sufficient water and stay hydrated
• Massage your head
• Take over-the-counter painkillers such as acetaminophen or ibuprofen to help reduce inflammation and relieve symptoms