Headache on the Back of the Head

Causes of a sudden headache:

• Migraine
• Severe dehydration
• Whiplash
• Ruptured brain artery aneurysm, stroke

Causes of a chronic headache:

• Stress
• Bad posture
• Herniated disc in the neck spine
• Brain tumor

Below, the causes of pain on the back of the head are listed as:

• Newly appearing
• Episodic
• Chronic recurrent
• Constant

If you have a newly appearing severe headache, call an ambulance (911 in US) right away and do not seek for online help. 

Sinusitis can sometimes cause pain on the back of the head. Pain on the top of the head, front or face, and stuffy nose are other likely symptoms. 

Cervicogenic headache. A herniated disc, injury, tuberculosis or cancer in the neck spine can also cause pain on the back of the head. Surgical repair of the spine is usually successful. 

Enlarged lymph nodes behind the ears in bacterial tonsillitis or infectious mononucleosis can be painful. Sore throat is the main symptom in both infections. Fungal infection of the scalp (Tinea capitis),folliculitis, and shingles (Herpes zoster) can cause pain and itchy rash on the back of the head. 

Brain tumor or cyst in the back part of the brain can cause slowly progressing headache that is worse in the morning. Neurological problems, like muscle weakness, problems with balance and mental changes, are often present before headache.

Within few hours after a head injury, an epidural hematoma can cause one-sided pain on the back of the head. Other common symptoms are dizziness, nausea, vomiting, seizures, impaired vision on one side, weakness or numbness in a limb. An urgent surgery is usually required. 

Infectious meningitis or encephalitis often starts with pain and stiffness at the back of the neck, high fever, nausea and sensitivity to light (photophobia). When bacterial meningitis is suspected, antibiotics should be taken right after a sample of blood is taken and before lumbar puncture and imaging investigations, since early onset of treatment usually has a good success, and late treatment might not prevent complications or death. Within hours, headache can spread over the entire head.

Infection of the middle ear and rubella can cause pain on the back of the head. 

Stroke or ruptured brain aneurysm may cause sudden (within a minute) severe, constant pain on the back of the head. An urgent surgery is usually required. Rarely, a sudden, severe headache that develops to full intensity within few minutes can appear without a know reason; this is called primary thunderclap headache. 

Whiplash is a neck injury after a fall or car accident resulting in pain in the neck and back of the head. An orthopedist can tell which investigations may be needed. A physiotherapist can contribute to recovery, which may last from several weeks to months.

Bad posture, eye strain or other physical or psychological stress can trigger tension headache, pressure-like pain, which can be limited to the back of the head (more or less symmetrically). 

Migraine headache can be limited to the back of the head on one or both sides.

In adolescent girls or young women, a menstrual period can, rarely, trigger basilar migraine, a throbbing headache on the back of the head, accompanied with blurred vision, slurred speech or other neurological symptoms.

High blood pressure is a rare cause of headache.

Sudden turning of the head in individuals with a pinched nerve in the neck spine can cause sudden pain on the back of the head, usually on one side and abnormal sensations on the same side of the tongue. This is called neck-tongue syndrome.

A brain tumor (right picture) or cyst in the back part of the brain may cause constant headache on the back of the head, usually worse in the morning. 

Constipation or dislocated uterus pressing upon the colon can cause constant headache. 

Enlarged lymph nodes in throat cancer can cause constant pain at the base of the skull. 

Inborn defects of the neck muscles, like torticollis (wry neck) or a cyst (syrinx) in the cervical spinal cord can cause constant headache.

Dehydration. Moderate or severe dehydration can be associated with headache, but not specifically with headache on the back of the head. If you are dehydrated, drinking water may help relieve headache, but if you are well hydrated, additional water will not likely help. Mineral and vitamin deficiencies that may cause headache:

• Iron deficiency with anemia
• Deficiency of various B vitamins
• Vitamin D deficiency
• Severely decreased sodium level in water intoxication often causes headache.

NOTE: If you have normal blood levels of minerals and vitamins, nutrient supplements will not likely relieve headache.

Chronic intoxication with copper, lead, mercury and other heavy metals may be associated with headache. There is a lot of information online how various cleansing methods can remove heavy metals from your body. If you do not actually have metal poisoning, these methods will not likely help you. It is a licensed doctor who can make a diagnosis of heavy metal poisoning based on blood and urine tests.

You can write the history of your headache and other health problems in the chronological order - this can greatly help your doctor to make a diagnosis and, eventually, save you some money by avoiding unnecessary investigations.

Try to answer these questions:

• How did headache appear (suddenly, slowly)?
• How long does it last or it lasted (seconds, weeks...)?
• Do you have any tender areas at the back of the head, neck or upper back?
• Do you experience any other symptoms, such as sore throat, toothache, skin rash, enlarged lymph nodes in the neck, nausea, fever, blurred vision or memory problems?
• Is your headache associated with a recent event, like injury or menstrual period?
• Do you have any chronic disease?
• Do headaches or chronic diseases run in your family?