Causes of Headache In The Back Of Head

We experience headache in different regions of our head. The type and location of the headache depends on the cause of the headache. Here, in this article, we have listed the various causes for headache in the back of the head.

Occipital Neuralgia produces severe, sharp headache in the back of head which spreads upwards or into the eye on the same side. Patient with Occipital Neuralgia will have an abnormal neck exam.

This type of headache originates in neck muscles and joints. Patient commonly does not feel pain in the neck, but feels pain in the back of the head which is usually on one side. Cervicogenic Headache can spread from back of the head towards the side of the head, ear or forehead. Patients suffering from with Cervicogenic Headache will commonly have a history of neck injury (whiplash injury) or a head injury. Having a poor posture also predisposes a person towards headache in the back of the head. Symptoms of this type of headache other than headache on the posterior side include limited neck movements. Flexion-Rotation Test can be done to identify abnormal neck movements. Physiotherapy is effective in relieving this type of headache in the back of the head.

Migraine also produces headache in the back of the head and sometimes in the neck also. The neck pain depends on the severity of the migraine. Patients with previous neck injuries may develop Migraine which causes headache in the back of the head. Migraine in the back of the head often is treatable and is caused due to problems with neck muscles or cervical spine.

This type of headache is felt in the area of temples mostly; however, some people can experience this pain exclusively in the back of the head.

Ice-pick headaches are intense, brief pains experienced in the head including in the back of the head. Ice-pick headaches last for a few seconds only. A brief sharp pain in the back of the head is caused by ice-pick headache. People can experience ice-pick headaches in the back of the head out of the blue. Patient will wince or can feel weak at the knees for a few seconds if the headaches are very intense. Ice-pick Headaches tend to occur in and around the eyes, but also occur in the very back of the head.

These are some Serious Causes of headache in the back of the head which if ignored and not treated properly can cause great harm.

Vertebral Artery Dissection can produce an abrupt severe headache in the back of the head; however, this occurs very rarely. It is difficult to differentiate between a vertebral artery dissection headache and cervicogenic headache. If the patient is having sudden sharp pains in the head then it is a medical emergency. If the patient has a history of recurrent episodes then it strongly indicates cervicogenic headache. A CT scan or MRA helps in excluding vertebral artery dissection.

Giant Cell Arteritis affects the occipital arteries which are present in the back of the head. Occipital arteries are present near the greater occipital nerve which is why Giant Cell Arteritis causes headache in the back of head. The diagnosis of Giant Cell Arteritis is made by ESR blood test and biopsy of the temporal artery. Immediate treatment is needed for Giant Cell Arteritis and steroids are used for treatment.

Subarachnoid hemorrhage produces an extremely sudden severe headache in the back of the head in about 10% of people. The cause of this type of headache is commonly a ruptured berry aneurysm which requires immediate medical treatment. This type of sudden severe headache in the back of the head produced by subarachnoid hemorrhage is termed as “Thunderclap Headache.”

Retropharyngeal Tendinitis causes severe headache in the back of the head such that the patient is not able to sleep because of the pain. Patient also experiences pain upon swallowing along with this headache. This type of headache in the back of the head caused by Retropharyngeal Tendinitis is often relieved by anti-inflammatory medicines. 

Parkinson’s Disease causes headache in the back of the head in patients who are known to suffer from low blood pressure related to Parkinson’s. The headache experienced is referred to as coat-hanger pain as the patient feels pain in the back of the head and neck which feels as if they are being suspended on a coat-hanger. 

In some cases, patients having brain tumor will experience headache in the back of the head, however, pain in the back of the head is not considered a characteristic feature of brain tumor. 

A person suffering from sleep apnea and heavy snoring is at an increased risk for chronic headaches and some of these headaches are situated at the back of the head. Treatment of sleep apnea helps in alleviating the headache and the risk of headache.

Some of the patients suffering from Idiopathic Intracranial Hypertension can also experience headaches in the back of the head which can also be accompanied with nausea and neck stiffness. Obese individuals are at an increased risk for developing this condition and reducing weight helps in preventing this type of headache. 

An overactive thyroid gland can also cause severe headache in the back of the head. Treating this disease helps in relieving the headache.

Adult Aqueductal Stenosis causes thunderclap headache which is felt in the back of the head.

A person suffering from Dengue Fever experiences headache along with fever. About 96% of patients suffering from Dengue Fever will be having a prominent headache out of which some of them will be experiencing it at the back of the head.

Sometimes people can experience Headache in the Back of the Head due to a physical stimulus such as: 

Mountain climbers can experience headache at the back of the head at high altitudes. It can involve the entire head or may be localized only in the back of the head. Half of these types of headache worsen with exertion.

Cough can also trigger Headache in the Back of the Head. The common cause of cough triggering a headache in the back of the head is Chiari Malformation. Stiff neck joints or muscular problems can also produce cough induced headache in the back of the head.

Headache in the back of the head occurring during sexual activity is felt as a sudden severe pain in the occipital area (back of head). Reversible Cerebral Vasoconstriction Syndrome may be responsible for these types of headaches.

Playing pool for extended periods of time can cause pain in the neck and head. The cause of this type of headache in the back of the head arises from the neck joints, such as from over-extension at the atlanto-axial joint. This is thought to be an occupational type of cervicogenic headache.

About half of the patients who are on dialysis for kidney failure suffer from a headache after the dialysis session. Patients suffering from hypertension are more prone to get a headache after dialysis which can also be located at the back of the head.

Headache in the back of the head can also be referred from the heart. Treating the heart problems will resolve this type of headache in the back of the head.

This is a treatable and rare headache which wakes a patient from sleep almost daily at about the same time. Patients suffering from hypnic headache go to bed pain free and are forced to wake up at the onset of the headache. Lithium Carbonate helps in about half of the patients suffering from hypnic headache. Caffeine also seemed to benefit patients with this type of headache.

This is a rare type of head syndrome which is triggered by rotation of the neck resulting in irritation of the C2 nerve and production of sharp pain in the neck, sensory disturbance in the tongue as well as headache in the back of the head.

This commonly occurs due to Spontaneous Intracranial Hypotension. Low pressure headache can be experienced anywhere including the back of the head; though often it is felt on both the sides of the head. There are some patients who will experience an intense dull ache in the back of the head. The characteristic feature of a low pressure headache is worsening of the headache when the patient is up and about and alleviation of the headache when the patient lies down. Other associated symptoms of low pressure headaches include buzzing in the ears or muffled hearing which also gets better upon lying down. Epidural blood patch is the most effective treatment for relieving this type of headache.

Rarely, a person can also experience severe headache in the back of the head due to Bulbocervical Cavernoma.

The characteristic pain in Chiari Malformation is headache in the back of the head. This type of headache in Chiari Malformation is triggered by exertion, coughing, sneezing or laughing.

Majority of the patients with occipital condyle syndrome have a known history of cancer in other part of the body leading to severe occipital pain from spreading of the cancer into the occipital bone.

Lateral atlanto-axial joint disease can cause C-2 Neuralgia. In this disease, there is thickening of the ligaments between the C1 and C2 vertebra or the joint capsule between C1 and C2 vertebrae gets affected. There may be compression of the C2 nerve root which causes acute sharp pains traveling up the back of the head. Patient may also experience watering of the eyes along with headache at the back of the head if there is irritation of the C2 nerve root.

Damage to the accessory nerve caused in the neck and shoulder which can spread to the back of the head. The common cause of accessory nerve damage is neck surgery for biopsy or for removal of a lymph gland. The patient’s shoulder on the affected side loses its shape and sags down.

Hypoglossal nerve palsy is a painful condition. When the inflamed nerve gets compressed in the hypoglossal canal, hypoglossal nerve palsy occurs; however the exact mechanism is not clear.

Epicrania Fugax is a variant of ice-pick headache but is shorter in duration and the pain tends to zig-zag through the head. There is no serious cause found for this type of headache.

This type of headache is also known as coin-shaped cephalgia and occurs in a localized area of pain in shape and size of a coin. The cause of this type of headache in the back of the head is thought to occur as a result of inflammation of the cutaneous nerves of the scalp. 

Some patients experience cluster pains in the back of the head which can also be accompanied with neck pain. The exact cause of this type of headache in the back of the head is not clear. In case of acute attacks, Sumatriptan injections and oxygen are effective. Verapamil helps in preventing this type of headache.

Also Read:

• Frontal Headache or Headache Across Forehead: Causes, Symptoms, Treatment
• What is Orthostatic Headache, know its Causes, Symptoms, Treatment, Prognosis, Pathophysiology, Epidemiology
• What Does Pressure in the Back of Your Head Indicate?
• Nummular Headache: Causes, Symptoms, Treatment