Headache in the back of the head: main causes and when to see a doctor

The back of the head starts to ache before you manage to call it pain: a heaviness at the base of the skull, as if a palm were placed on your neck and slowly pressing down. Almost everyone is familiar with this — 90% of people experience a headache at least once a year. Most often it goes away on its own and does not signal danger, but there are situations in which waiting is not an option.

Headache in the back of the head: how it manifests

Headache is pain above the conventional line connecting the outer corner of the eye, the external auditory canal, and the first cervical vertebra; anything below that is already facial or neck pain. The brain itself has no pain receptors. A person feels pain from those areas of the head and neck where receptors are present: extracranial arteries and veins, cranial and spinal nerves, neck and head muscles, and the meninges.

An attack lasts from 30 minutes to several hours, sometimes several days.

Main causes of pain in the back of the head and neck

The most common form is tension-type headache: it arises from tense muscles of the shoulders, neck, scalp, and jaw and is often associated with stress, depression, or anxiety. Cervicogenic headache is associated with neck pathology; it belongs to secondary headaches, and some of them, like cervicogenic headache, are not dangerous.

• a cold or flu, stress, alcohol;
• poor posture and vision problems;
• irregular meals and insufficient fluid intake;
• taking painkillers too often;
• hormonal changes — menstruation, menopause.

Serious causes are less common, and warning symptoms ("red flags") may point to them. Such causes include meningitis, subarachnoid hemorrhage, increased intracranial pressure, giant cell arteritis in older adults, angle-closure glaucoma, and carbon monoxide poisoning. At the same time, 95–98% of all headaches are primary, that is, not the consequence of another disease.

Pain in the back of the head and vision problems

If pain in the back of the head is accompanied by vision problems or pain in the eye area, this is a reason to seek help without delay. In angle-closure glaucoma, the pain is concentrated in the eye area and is accompanied by visual impairment, nausea, vomiting, redness of the eye, and pupil dilation.

Occipital pain and pressure: is there a link

With increased intracranial pressure, the pain intensifies when changing body position, becomes stronger in the morning, and is accompanied by vomiting. Causes include a brain tumor, idiopathic intracranial hypertension (more often in young women with excess weight), and, in rare cases, thrombosis of the dural sinuses. Pain that appears or worsens with coughing, sneezing, bending over, or exertion is a separate warning sign.

What symptoms accompany pain in the back of the head

Fever together with a stiff, inflexible neck suggests possible meningitis. Confusion may indicate encephalitis, and general weakness may indicate a stroke or tumor. Sudden, extremely severe ("thunderclap") pain can be the only symptom of subarachnoid hemorrhage. In older adults, headache, especially with visual impairment and jaw pain when eating, may be a sign of giant cell arteritis. Carbon monoxide poisoning causes headache with nausea, dizziness, and muscle weakness.

When pain in the back of the head requires urgent medical attention

You should see a doctor if the pain does not go away or worsens, and also if you have headaches regularly. Cephalalgias are diagnosed by a cephalalgologist — a neurologist specializing in headache; they assess the nature of the pain, accompanying symptoms, and, if necessary, prescribe examinations.

Occipital pain by itself is not a reason to call an ambulance; 103 or 112 — if together with it there are seizures, numbness or weakness in the body or face, impaired speech, balance, walking, or memory, the person is drowsy or confused, the severe pain arose suddenly and is extremely intense, there was a head injury in the last three months, vision is lost, there is a rash that does not fade when pressed with glass, very high fever, a stiff neck, or sensitivity to bright light.

This material is for reference and does not replace a doctor's consultation: if the back of the head hurts regularly, this is a reason to investigate the causes together with a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer