Table of ContentsView AllTable of ContentsTension HeadachePoor PostureSpinal Fluid LeakageCervical ArthritisPhysical ExertionOccipital NeuralgiaMigraineDehydrationCluster HeadacheWhen to Seek Treatment
Table of ContentsView All
View All
Table of Contents
Tension Headache
Poor Posture
Spinal Fluid Leakage
Cervical Arthritis
Physical Exertion
Occipital Neuralgia
Migraine
Dehydration
Cluster Headache
When to Seek Treatment
A headache in the back of the head can have many causes. These includeprimary headacheslike migraines which occur on their own without an underlying cause andsecondary headacheswhich are symptoms of an underlying disease or condition. Nerve injury can also lead to back-of-the-head pain.
Tension headaches are one of the most common causes of pain in the back of the head, but there are other possible explanations. These range from arthritis and neck injuries to poor posture and dehydration.
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Atension headacheis the most common type of primary headache, accounting for nearly 90% of all headaches.
Tension headaches cause a gripping pain around the lower back of the head that can radiate to the neck and eyes. The headaches may be mild to moderate in intensity and are typically bilateral (affecting both sides of the head).
Other possible symptoms include:
Tension headaches are thought to be caused when neck and scalp muscles suddenly tighten. Possible triggers include stress, depression, anxiety, and head injury.
Poor Posture and Muscle Contraction Headaches
Poor posture can cause tension in your upper back, neck, and shoulders, leading to a specific form of tension headache known as a muscle contraction headache.
The pericranial muscles are thought to contain the trigger points associated with muscle contraction headaches. These include muscles of the head and neck such as:
When you slump or have generally poor posture, it can physically stress trigger points on these muscles and release a chemical calledsubstance P (SP)involved in pain signaling.
Poor posture can also cause the obstruction of blood flow (ischemia), triggering the release of inflammatory chemicals calledcytokinesthat can instigate localized, back-of-the-head pain.
Muscle contraction headaches are typically bilateral, causing a pressing or band-like tightness around the back of the head. The pain may be chronic (persistent) and worsen in episodes, particularly at the end of the day when muscles are tired. Shoulder or neck muscle tightness may also accompany.
Low-Pressure Headache
A low-pressure headache, also known asspontaneous intracranial hypotension, is a type of secondary headache caused whencerebrospinal fluidfrom the brain and spinal cord leaks through a tear in the surrounding membrane (called thedura mater). The tear may occur after aspinal tapor followingepidural (spinal) anesthesia.
The leakage of cerebrospinal fluid causes a sudden drop in pressure, triggering severe headache pain on both sides of the back of the head.
Other symptoms include:
A low-pressure headache is felt while sitting or standing and worsens with coughing, sneezing, or exercising. The headache will usually resolve within 20 to 30 minutes of lying flat.
Cervicogenic Headache
Cervicogenic headaches cause unilateral (one-sided) pain that starts in the neck and radiates from the back of the head to the front. The pain is usually moderate to severe in intensity, non-throbbing, and worsens with head or neck movement.
Exertion Headache
Exercise-induced headaches, also known asexertion headaches, cause pain during or immediately after physical activity. It is a type of primary headache thought to be caused when blood vessels rapidly expand to deliver more blood to the head. This, in turn, increases pressure in the skull.
Exertion headaches can last for minutes, hours, and sometimes days. They tend to affect males around 40 who exercise strenuously. The pain is typically bilateral and is often described as throbbing or pulsating.
Other symptoms may include:
The underlying cause of exertion headaches is thought to bevenous insufficiency(in which veins have problems moving blood back to the heart). A common cause of venous insufficiency is aheart valve problem, often unrecognized in the early stages.
As such, persistent exertion headaches may be a sign that you need to see acardiologist.
Occipital neuralgia is unilateral and causes severe, sudden stabbing or shooting pain that begins in the neck and radiates to the top of the head.
Occipital Migraine
Although migraines are typically unilateral, affecting one side of the head only, certain types can affect the neck and face or cause all-over head pain.
While tension headaches can often be treated with over-the-counter (OTC) pain relievers, migraines may requireprescription medicationslike Imitrex (sumatriptan), Maxalt (rizatriptan), and Migranal (dihydroergotamine) nasal spray.
Dehydration Headache
A primary dehydration headache can occur when your water intake hasn’t kept up with your body’s demand for fluids. Dehydration is a common cause of headaches including migraines, especially in warm weather months.A secondary type can occur when dehydration affects another process in your body and the headache follows.
With dehydration, other symptoms like thirst may occur with the migraine or tension-type headache pain at the back of your head. These symptoms also can include:
To avoiddehydration headaches, drink plenty of water. You also can add fruits and other foods with high water content into your diet.
Cluster headachesare a type of primary headache that causes severe recurrent attacks of pain on one side of the head, typically around the eyes or temples. The symptoms arise suddenly without a visual"aura"commonly associated withmigraines.
A cluster headache is often described as being worse than a migraine with burning, stabbing, drilling, or squeezing pain.
The headaches are so-named because they occur in clusters, ranging from one attack every two days to eight or more attacks per day. Each episode can last anywhere from 15 minutes to three hours.
When to See a Healthcare Provider
Most headaches are not dangerous. There are instances, however, when a headache warrants avisit to your healthcare provider, such as when:
When to Call 911
Call 911or go to your emergency room if your headache:
Summary
Some of these start with pain in the back of the head, while others start elsewhere on the head or neck. The location, speed, severity, and duration of the pain can give you clues as to the underlying cause.
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