What is this pain in the back of my head?

Tension-type headaches
Migraine
Medication-overuse headache
Occipital neuralgia
Exercise-induced headaches
Summary
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A headache can be either the main reason for pain or a secondary symptom of problems in another part of the body. There is not always an explanation for why primary headaches occur, and the cause and location of the pain can vary.

This article looks at five of the most common causes of pain in the back of the head:

tension-type headaches
migraine
medication overuse headaches
occipital neuralgia
exercise-induced headaches
We also take a look at their symptoms, possible treatments, and prevention methods.

1. Tension headaches

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A tension headache may last between half an hour to several days.
Tension or tension-type headaches (TTH) are the most common cause of pain in the back of the head. They can last for up to 7 days, but they can also be brief, lasting for as little as 30 minutes.

The symptoms of a TTH are:

a feeling of tightening around the back or front of the head
pain that is mild to moderate but occasionally severe
not made worse by exercise
no nausea or vomiting
Treatment

Taking pain relief such as aspirin or acetaminophen is usually enough when tension headaches are infrequent.

When they occur more frequently, alternative treatments may help to reduce how often and how long they occur for.

Treatment options include:

relaxation techniques
cognitive behavioral therapy (CBT)
massage
physical therapy
acupuncture
Causes and prevention

The cause of TTH is not currently known, but several factors are potential triggers. These include:

stress
tiredness
lack of sleep
missing meals
poor posture
arthritis
sinus pain
not drinking enough water
2. Migraine

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A migraine may cause sensitivity to light and visual disturbances.
Migraines are a common type of recurring headache that often start during childhood and increase in frequency with age.

In adulthood, they can occur several times a week, especially in females between the ages of 35 and 45 years.

Common symptoms include:

throbbing intense pain on one side of the head
nausea and vomiting
visual disturbance
heightened sensitivity to light, noise, and smell
muscles tenderness and sensitive skin
last from a few hours to several days
physical activity makes them worse
An “aura” might precede a migraine, in which the person experiences flashing lights or other visual disturbances.

Triggers

A variety of factors that are specific to each person might trigger migraines.

These factors may be emotional, physical, environmental, dietary, or relate to medication and include:

anxiety, stress, and depression
flashing and bright lights, loud noises, strong smells
lack of food
inadequate sleep
certain food types, such as cheese, chocolate, and caffeine
hormone changes
taking a contraceptive pill
Causes and treatment

Inflammatory substances that trigger pain sensors in the blood vessels and nerves of the head might cause migraines.

The treatment of migraines should involve analgesics, such as aspirin or acetaminophen, and resting in a darkened room.

If normal analgesics do not work, then a doctor might prescribe antimigraine drugs known as triptans. These drugs cause blood vessels to shrink and contract, which reverses the changes in the brain that cause migraines.

The sooner a person receives treatment for a migraine attack, the more effective that treatment will be.

Prevention

People can take certain steps to reduce the risk of having a migraine. These steps include:

medication used for epilepsy, depression, and high blood pressure
stress management, exercise, relaxation, and physical therapy
noting down and avoiding personal triggers, including avoiding certain foods
hormone therapy

3. Medication-overuse or rebound headache
Medication-overuse headaches (MOH) may develop if a person uses too much pain relief medication for other types of headaches. MOH headaches are also known as rebound headaches.

Occasional use of pain relief does not cause any problems. However, when a person take pain relief medication headaches more than two or three times a week over an extended period, a MOH or rebound headache can occur.

The main symptoms include:

persistent, almost daily headaches
worse pain when waking
a headache after stopping pain relief
Other problems associated with MOH are:

nausea
anxiety
irritability
lack of energy
physical weakness
restlessness
difficulty concentrating
loss of memory
depression
Treatment

The best treatment for MOH is often to stop taking pain relief medication entirely. Headaches will become worse at first but will quickly resolve. A person can then continue taking their normal or preferred pain relief medication.

In more severe cases, people should see a doctor. An individual may need physical or behavioral therapy to break the cycle of using pain relief.

For certain medications, such as opioids, a doctor will need to recommend a gradual reduction in dosage, as instantly stopping some medications is dangerous.

Prevention

To prevent MOH, avoid using pain relief medication for headaches more than a couple of times per week. If headaches requiring pain medication are persistent and frequent, seek advice from a doctor.

4. Occipital neuralgia

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Physical therapy or massages may help to treat mild to moderate occipital neuralgia.
Occipital neuralgia (ON) is a distinctive headache that tends to begin at the base of the neck and spreads up to the back of the head, then behind the ears.

It may relate to 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 the damage or irritation.

The pain in occipital neuralgia can be severe. Other symptoms include:

continuous throbbing and burning ache
intermittent shocking or shooting pains
pain is often on one side of the head and can be triggered by moving the neck
tenderness in the scalp
sensitivity to light
Diagnosis

Due to the similarity of the symptoms, a person or medical professional might mistake ON for a migraine or another type of headache. A distinguishing feature of ON is pain after applying pressure to the back of the neck and scalp.

Sometimes, a doctor may diagnose ON by injecting local anesthetic close to the occipital nerves, providing a temporary nerve block. If pain decreases, then a doctor will likely diagnose ON.

As ON can be a symptom of other disorders, the doctor may also check for other underlying conditions.

Causes

Possible causes include:

damage to the spine or discs
osteoarthritis
tumors
gout
nerve damage caused by diabetes
inflammation of blood vessels
infection
Treatment

Applying heat packs, resting, massage, physical therapy, and taking anti-inflammatory medications, such as aspirin or naproxen, can help reduce pain levels. Various types of heat packs are available online.

If pain is severe, a person with ON may need to take oral muscle relaxants or nerve blocking medications. For extreme pain, local anesthetic or steroid injections are used.

On rare occasions, surgery may be necessary to reduce pressure on the nerves or block pain messages to this part of the body.