What Causes Headaches in the Back of the Head and Neck? - AICA Orthopedics (2023)

While headaches are a very common ailment that everyone has dealt with, many don’t realize how many types of headaches there are. Everything from the location of the pain to what it feels like can vary depending upon the cause of the headache, and this information can be crucial to understanding if there is a severe cause for the condition. Any pain in any region of the face, head, or neck is technically considered a headache- but what exactly causes the kind of pain that is in the neck and the back of the head? Read on to understand this phenomenon and what kind of headache treatment is right for these symptoms.

Types of Headaches

What Causes Headaches in the Back of the Head and Neck? - AICA Orthopedics (1)

In general terms, a headache is any pain that originates in the face, head, or neck. However, the International Headache Society categorizes over 150 types of headaches that a person can suffer from, with three main categories. These are:

  • Primary headaches are headaches with no clear underlying cause. They may result from overactivity or strain, like a headache that comes from sleeping in an odd position. These are usually not life-threatening or of great concern, but they can impact quality of life. Primary headaches include tension headaches, migraines, and cluster headaches.
  • Secondary headaches are a result of underlying medical conditions like infection, injury, tumors, bleeding in the brain, or even life-threatening causes. Examples include a sinus headache or a medication overuse headache.
  • Other headaches include headaches, facial pain, and pain involving the 12 cranial nerves that don’t fall into the other categories. An example is a trigeminal headache.

Each of these categories may be treated differently depending on how they present and how the person is impacted.

Headaches in the Back of the Head and Neck

Certain types of headaches are more likely to cause pain in the back of the head and the neck than others. For example, a sinus headache will cause pain in the sinuses, which sit at the front of the face- it is unlikely neck pain is a result of a sinus headache. Below are some types of headaches commonly associated with pain in the back of the head and the neck.

Tension Headaches

The most common cause of pain in the back of the head is a tension headache. These headaches can last anywhere from 30 minutes to seven days and are usually associated with pressure or tension in the back of the head. The tightening feeling may stretch around to the front of the head and can range from mild to severe.

Tension headaches can be a response to situational issues, like sleeping with the neck in an odd position or more chronic lifestyle factors. Severe stress, fatigue, a lack of sleep, skipping meals, bad posture, and a lack of hydration are all commonly associated with an increase in tension headaches.

Common treatments for tension headaches include lifestyle modifications, painkillers, massage, and relaxing techniques like meditation. Occasional headaches in this category are not a cause for concern, but recurrent or severe headaches should be reported to a doctor.


A form of recurring headaches, migraines often begin in childhood and increase with frequency over time. While they are most commonly seen in females, anyone can experience migraine. They are categorized by severe pain on one side of the head, nausea or vomiting, and visual disturbance. It is also common to experience sensitivity to sound, taste, and light or have the pain worsened by physical activity. The pain may last anywhere from a couple of hours to several days.

The exact cause of migraine is not known, but they can often be triggered in those who are prone to emotional and physical stress or dietary changes, as well as certain medications. Painkillers and resting in a dark room are usually used to manage pain, while some lifestyle modifications and medications like triptans can help manage the condition more long term.

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Medication Overuse or Rebound Headaches

When a person uses too many painkillers, they can develop a medication overuse headache. These typically begin after stopping pain medication and are characterized by persistent and severe headache pain. Other symptoms may include nausea, fatigue, anxiety, irritability, restlessness, trouble concentrating, loss of memory, or even depression.

The best treatment for these headaches is to stop taking the pain relief medication entirely. Headaches will worsen at first and quickly resolve, though this should be done under the supervision of a doctor. Some people may require physical or behavioral therapy to break an addiction to medication as well.

Occipital Neuralgia

This rare but severe headache usually begins in the base of the neck, spreading up to the back of the head and behind the ears. It occurs when there is damage or irritation to the occipital nerves, which run up the back of the neck to the base of the scalp. This nerve damage and irritation can result from underlying diseases, neck tension, or unknown factors. Common causes can include damage to the spine, tumors, nerve damage caused by diabetes, swelling of the blood vessels, or infection.

The pain of occipital neuralgia is described as severe, with a burning or shooting sensation. It is typically on one side of the head and worsens with neck movement. Patients may also experience sensitivity to light.

Treatment options may include rest, massage, heat therapy, physical therapy, and the use of pain medication with anti-inflammatory properties. In more severe cases, medication like muscle relaxants, nerve block injections, steroid injections, and local anesthesia may be used. Rare cases may call for surgery to reduce pressure on the nerves or block pain impulses to this part of the body.

Exercise-Induced Headaches

Stressed physical activity can cause headaches, which typically begin immediately after stopping the exercise. These may feel like a throbbing pain on both sides of the head, which lasts from five minutes to two days. An exercise-induced headache can be an isolated event brought on by things like weightlifting, running, sexual intercourse, or even straining on the toilet.

Treatment may include taking painkillers prior to exercising, avoiding activities that trigger an event, maintaining a healthy and balanced diet, and getting sufficient sleep.

Cervicogenic Headache

Pain that comes from the neck but is felt in the head is known as a Cervicogenic headache. These commonly result from an injury like whiplash or a pinched nerve, though they can also be caused by a neck fracture, a sprain, or arthritis.

The pain from a Cervicogenic headache is often on only one side of the head, and the pain usually begins at the bottom of the skull, traveling up one side of the head. Neck stiffness and discomfort when turning the head is also common. Sneezing or coughing can worsen symptoms.

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Treatment for these headaches involves treating the injury itself, often through chiropractic care and physical therapy, though more intervention may be needed for more serious injuries. Once the neck has regained strength and flexibility, the pain is typically relieved without lasting headaches or other symptoms.

Other Causes of Headaches

In addition to these specific headache types, there are some general risk factors and considerations that can help you understand what may be causing your symptoms.

Illness and Injury: Common illnesses like colds, fevers, and viral infections are likely to lead to headaches that can manifest in the back of the head. If you have had a fall or car accident that led to a blow to the head, this can also be an explanation for a headache and should be checked.

Stress: Emotional stress and depression can cause headache pain. These situations can also cause behaviors that lead to headaches, like alcohol use, skipping meals, and changes in sleeping patterns.

Environment: Many headaches are triggered by surrounding sensory input. Secondhand tobacco smoke and strong smells like household chemicals or perfumes are common examples. Certain foods and allergens may also be a trigger for some people. Stress, pollution, noise, lighting, and weather changes are also known to induce headaches in those prone to them, especially migraine headaches.

Genetics: A tendency to suffer from headaches, particularly migraine headaches, can run in families. Most children and teens who have migraines have other family members who experience them.

When to Seek Medical Care

Many types of headaches are common, and experiencing them occasionally or in response to a trigger is not cause for concern. However, any severe or recurrent pain is a sign you should seek medical care to rule out more severe causes and find ways to manage the pain.

You should always call your doctor if:

  • Headache pain is severe or sudden
  • Pain gets worse with time
  • You experience personality changes or mood shifts
  • You have a fever along with your headache
  • You notice confusion or memory problems
  • You feel sluggish
  • Jaw pain, vision problems, or a sore scalp occur

Diagnosing the Cause of Headaches

Understanding the exact type of headache you are suffering from and the potential causes can help you to begin a treatment plan that reduces or eliminates your pain. The first step to finding this diagnosis is speaking with a doctor about your headaches. They will ask you about your symptoms- the more information you can provide, the better they will be able to understand your concerns. Anything you can share about what causes the headache, how they feel, what helps or worsens them, and family history will all be important.

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Most of the time, diagnostic tests will not be a large part of finding the cause of your headaches. Unless they are caused by a visible and distinct injury or condition that would appear on scans, they will not provide much clarity. However, your doctor may order a CT scan or MRI to look for certain issues or to rule out underlying conditions. They may also perform basic neurological exams of your mental status, motor strength, vision, and reflexes to assess your overall nerve function.

One scan that may be used is an MRA, or magnetic resonance angiogram. This is similar to an MRI and is used to see blood vessels in the brain, which can highlight any factors restricting or increasing blood flow. These blockages may trigger headaches and, if they can be identified, can be addressed through medication and procedures like a nerve block. An MRA will usually be performed when other methods have not been successful in identifying a cause for headaches.

In the case of a secondary headache, treating the underlying issue is the focus, rather than the headaches themselves. But with a primary headache, understanding the type of headache can help you not only manage symptoms, but also understand the causes of the episodes so you can reduce or eliminate the number of headaches that occur.

Treating Headaches

The way you treat a headache will depend largely on the exact cause of the headache, any related condition, and your goals and prognosis. Headache treatment can generally be split into 4 categories:

  • RescueWhat Causes Headaches in the Back of the Head and Neck? - AICA Orthopedics (2)
  • Prevention
  • Lifestyle modifications
  • Complementary medicine strategies


When a headache is starting or has started, finding a way to manage the pain is known as rescue. This can be a combination of medication and other methods that either reduce symptoms or prevent them from worsening. For example, those who suffer from migraine headaches often find a cool, dark space where they can rest and avoid as much sensory input as possible. While this does not reverse the headache or eliminate pain, it addresses the sensitivity and pain that a migraine can cause and avoids anything that may worsen the condition.

Some patients do find that taking medication early can stop the headache from progressing. This can include over-the-counter options like NSAIDs or aspirin, as well as prescribed medications. Toradol is a self-administered injection that can treat acute headaches, and corticosteroids can also be used in some cases.

Rescue tactics may also involve trying to stop accompanying symptoms, like nausea. Triptans are commonly prescribed to those with migraine headaches to reduce nausea and vomiting during an episode.


Preventing headaches can mean different things in different types of headaches. Avoiding known triggers can be a form of preventing headaches, as can treating underlying conditions that are known to cause headaches. It is important to understand these causes and triggers in order to create a plan that prevents headaches. This is often more successful than a rescue plan as it seeks to stop the headache from occurring, bypassing pain and other symptoms.

It can be helpful to keep a headache diary and track the duration and symptoms of each headache. When one happens, take note of what you did that day, what you ate, and anything unusual about the environment. Over time you can try to identify patterns that may contribute.


Lifestyle Modifications

Even where there is not a known underlying condition, many small lifestyle changes can make a big difference in terms of headaches. This can also be used as a process of elimination to help determine what does or doesn’t bring on a headache.

Some examples of lifestyle modification that can help with headaches include:

  • Avoiding overuse of medication
  • Getting enough sleep
  • Sleeping in a neutral position
  • Eating regular meals
  • Engaging in regular physical activity
  • Reducing stress
  • Reducing or eliminating caffeine
  • Moderating alcohol intake
  • Quitting tobacco use
  • Practice good posture
  • Avoid screen time and use blue light glasses when on a screen
  • Ensure you have the right prescription and use glasses or contacts as needed
  • If you have long hair, avoiding tight ponytails or braids
  • Drink plenty of water, especially before drinking alcohol
  • Cut out caffeine and other substances slowly to avoid withdrawal

Complementary Medicine Strategies

While there is no single medical procedure that can help all headaches, a variety of treatments are available that may help address the root cause or relieve symptoms.

When the pain is caused by an injury or physical ailment, chiropractic care and physical therapy can be helpful. By ensuring the spine is aligned and the muscles in the neck are strong, these practices help to prevent pain and headache as a result of injury and weakness. This is especially applicable if something like whiplash is contributing to the pain.

Neurological treatment may also be necessary, especially in cases of damage like occipital neuralgia.

Treating the Back and Neck for Headache Pain

Not all headaches are related to the neck and spine, but they are often contributing factors. Ensuring that the spine, including the cervical spine, is properly aligned and able to do the important work of supporting the head is one way to avoid headaches. Physical therapy and consistent chiropractic adjustments can help ensure the neck is strong, your posture is optimized, and the body is able to fight off any additional health concerns that may contribute to headaches.

At AICA Orthopedics, our holistic team of experts is dedicated to ensuring you find relief. Physical therapists, chiropractors, neurologists, orthopedists, pain management specialists, and others will work together to identify any contributing factors and develop a personalized plan based on your needs and goals. Contact AICA Orthopedics today to schedule your first appointment and begin finding relief.

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What does a headache in the back of your head and neck mean? ›

Headaches felt at the back of the head are usually tension-type headaches. A "back of the head" headache may also stem from an underlying health condition like arthritis or an irritated nerve in your neck or scalp. Once your headache type is diagnosed, treatment is usually fairly simple.

What does a headache at the back of the skull mean? ›

Back of your head

This type of headache can also be due to poor posture or neck problems such as a herniated disc. A back of the head headache, often accompanied by neck pain, can also be a sign of a low-pressure headache, otherwise known as spontaneous intracranial hypotension (SIH).

What neurological problems cause headaches? ›

Conditions that might cause nonprimary chronic daily headaches include:
  • Inflammation or other problems with the blood vessels in and around the brain, including stroke.
  • Infections, such as meningitis.
  • Intracranial pressure that's either too high or too low.
  • Brain tumor.
  • Traumatic brain injury.
Apr 9, 2019

How do you get rid of a headache in the back of your head and neck? ›

Apply heat to relieve tense neck and shoulder muscles. Use a heating pad set on low, a hot water bottle, a hot shower or bath, a warm compress, or a hot towel. Or apply ice or a cool washcloth to the forehead. Massage also can relieve muscle tension — and sometimes headache pain.

When should I worry about headaches in the back of my head? ›

Your headache comes on suddenly and is explosive or violent. Your headache is "the worst ever," even if you regularly get headaches. You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache. Your headache gets worse over 24 hours.

Is headache in back of head serious? ›

Sometimes, a throbbing headache in the back of the head might be a sign of an underlying health condition, such as migraine, IH, or occipital neuralgia. Anyone who thinks that an underlying health condition is causing their headaches should speak with a doctor.

What diseases start with headaches? ›

13 Common Headache Disorders
  • Cluster Headaches. Cluster headaches are one of the most painful types of primary headache disorders. ...
  • Classic Migraine. ...
  • Common Migraine. ...
  • Tension Headache. ...
  • Exertional Headache. ...
  • Sinus Headache. ...
  • Aneurysm. ...
  • Tumor.
Aug 14, 2019

What will a neurologist do for headaches? ›

A neurologist can help by doing a complete evaluation and ordering tests, if needed. They will work with you to determine the cause of your headaches and develop a treatment plan to help you find relief.

What are some diseases that cause headaches? ›

Possible causes of secondary headaches include:
  • Acute sinusitis (nasal and sinus infection)
  • Arterial tears (carotid or vertebral dissections)
  • Blood clot (venous thrombosis) within the brain — separate from stroke.
  • Brain aneurysm.
  • Brain AVM (arteriovenous malformation)
  • Brain tumor.
  • Carbon monoxide poisoning.

What kind of tumor causes cervicogenic headache? ›

Nasopharyngeal cancer can occur in any age group and is often misdiagnosed. Cervicogenic headache (CEH) is a clinical condition, putatively originating from nociceptive structures in the neck. A patient with CEH-like symptoms occurring as a result of nasopharyngeal cancer invasion is reported.

Do brain tumors cause pain in back of head? ›

Symptoms that accompany a brain tumor headache

double vision, blurred vision, or a loss of vision. increased pressure felt in the back of the head.

What type of headache goes up the back of your head? ›

If you experience headaches that radiate from the neck to the back of your head, you may have a cervicogenic headache. A cervicogenic headache is a secondary headache, which means that it is caused by another illness or physical issue.

Why won't the headache in the back of my head go away? ›

There are numerous potential causes, including migraine, a head injury, or a viral illness, such as COVID-19. Anyone who has a headache for days that does not respond to over-the-counter (OTC) pain relief medication should seek guidance from a doctor.

Is it normal to have a headache every day? ›

No, it's NOT normal to get headaches everyday

Most people have headaches from time to time. But if you have a headache more days than not, you might have chronic daily headaches, which come in many forms – most of them pretty disabling.

What is chronic daily headaches? ›

A patient who has headaches as many days as not — at least 15 days per month — is said to have chronic daily headache (CDH). Not a specific type of headache, CDH is rather a descriptive term applied to any number of headache types. Headaches that can occur on a daily or near daily basis include: Cluster.

Why do I wake up with a headache everyday? ›

A number of sleep or health disorders, as well as personal habits, can trigger a headache when you wake up. Sleep apnea, migraine, and lack of sleep are common culprits. However, teeth grinding, alcohol use, and certain medications can also cause you to wake up with a headache.

Can an orthopedic doctor help with headaches? ›

At AICA Orthopedics, we have multiple orthopedic doctors and specialists who not only diagnose why you're feeling pain and discomfort but also provide effective, personalized treatment for your headaches and related conditions.

What can doctors do for constant headaches? ›

Options include topiramate (Topamax, Qudexy XR, others), divalproex sodium (Depakote) and gabapentin (Neurontin, Gralise). NSAIDs. Prescription nonsteroidal anti-inflammatory drugs — such as naproxen sodium (Anaprox, Naprelan) — might be helpful, especially if you're withdrawing from other pain relievers.

What is the best doctor to see for headaches? ›

A visit with your primary care physician is a good place to start for headaches that are not disabling but more of a nuisance. However, immobilizing headaches may warrant a trip to a neurologist. “Patients should see a neurologist for any headache that is disabling,” McLauchlin said.

What are three neurological disorders other than migraines? ›

Some common types of neurological disorders include headache, epilepsy, stroke, Alzheimer's disease, and Parkinson's Disease. These diseases affect different aspects of the nervous system and have their own associated causes, symptoms, and treatments.

How do you know if you have a neurological problem? ›

Physical signs of neurological problems may include partial or complete paralysis, muscle weakness, seizures, unexplained pain, or numbness. Spasticity is when muscles become tense and rigid and your reflexes may be exaggerated. This can affect the way you walk, move, or even speak.

Do headaches come under neurology? ›

A migraine is a common neurological condition that causes a variety of symptoms, most notably a throbbing headache on one side of your head. Migraines often get worse with physical activity, lights, sounds or smells. They usually last at least four hours or even days.

What are signs of neurological dysfunction? ›

  • Weakness or paralysis.
  • Abnormal movement, such as tremors or difficulty walking.
  • Loss of balance.
  • Difficulty swallowing or feeling "a lump in the throat"
  • Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures)
  • Episodes of unresponsiveness.
Jan 11, 2022


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