November 2026

Pain in the Back of Your Head: Causes and Relief

By Your Health Magazine Health Information Team

If your head is hurting in back, the cause is often a tension-type headache, tight neck muscles, migraine, or pain referred from the neck. Brief electric-shock pain may come from irritated occipital nerves. Location alone cannot identify the cause, however, and sudden or severe back-of-head pain with neurological symptoms, fever, a stiff neck, or a recent injury requires prompt medical attention.

Common Causes of Pain in the Back of the Head

Back head pain may begin in the scalp, pain-sensitive structures around the head, or the upper neck. The way the pain feels and the symptoms accompanying it provide more useful clues than location by itself.

Possible cause	Typical pattern	Other clues
Tension-type headache	Dull pressure or tightness that may involve the back of the head and neck	Scalp, jaw, neck, or shoulder tenderness; stress, poor sleep, prolonged screen use, or awkward posture
Migraine	Moderate to severe pain that may be throbbing and can affect one side or the back of the head	Nausea, light or sound sensitivity, visual changes, or worsening with routine activity
Cervicogenic headache	Pain that starts in the neck or base of the skull and travels upward, often on one side	Reduced neck movement or pain that worsens with particular neck positions
Occipital neuralgia	Brief shooting, burning, tingling, or electric-shock pain in the back of the scalp	Scalp tenderness, pain when lying on a pillow, or discomfort radiating toward one eye
Head or neck injury	New pain following a fall, collision, sudden neck movement, or blow to the head	Dizziness, nausea, confusion, balance problems, or increasing pain

Tension-type headache is the most common headache disorder. Tight or tender muscles may contribute, although headache biology is more complex than muscle tension alone. The National Library of Medicine provides an overview of headache types, diagnosis, and treatment.

When the Pain May Be Coming From the Neck or Nerves

A headache associated with neck discomfort is not automatically cervicogenic. Migraine and tension-type headaches can also cause neck pain. A true cervicogenic headache is referred from a problem involving structures in the cervical spine or surrounding tissues. According to the American Migraine Foundation’s guidance on cervicogenic headache, reduced neck range of motion and pain triggered by neck movement or pressure are common clues.

Occipital neuralgia has a different quality. Irritation of the nerves that travel from the upper neck into the scalp can produce sharp, zapping pain and marked scalp sensitivity. Because migraine and other headaches can resemble nerve pain, a clinician may need to distinguish them. Learn more from Johns Hopkins Medicine’s overview of occipital neuralgia.

Steps That May Provide Relief

For a familiar, mild headache without warning signs, these measures may help:

Rest your eyes and change position. Step away from screens or close work. Relax your jaw, lower your shoulders, and avoid holding your head forward.
Drink water and eat if you missed a meal. Dehydration and changes in eating patterns can trigger headaches in some people.
Try heat or cold. A warm shower or warm compress may relax tender neck muscles. Some people prefer a cool pack on the painful area. Protect the skin and limit exposure to short intervals.
Use gentle movement. Slowly move the neck within a comfortable range. Stop if movement causes sharp pain, dizziness, numbness, weakness, or worsening symptoms.
Consider an over-the-counter pain reliever. Acetaminophen, aspirin, ibuprofen, or naproxen may help certain headaches when used according to the product label. Ask a clinician or pharmacist first if you are pregnant, take blood thinners, have kidney or liver disease, have a history of stomach ulcers, or take other medicines.

Frequent use of pain medicine can contribute to medication-overuse headaches. If you regularly need headache medicine more than a couple of days per week, discuss the pattern with a healthcare professional rather than continuing to increase how often you take it.

Track Patterns and Triggers

A brief headache diary can help a clinician understand why your head hurts at the back. Record:

When the pain begins and how long it lasts
Whether it is dull, throbbing, burning, or shock-like
Whether it affects one or both sides
Neck stiffness or reduced movement
Nausea, light sensitivity, vision changes, numbness, or weakness
Recent sleep, meals, fluid intake, stress, exercise, injuries, and screen time
Medicines taken and whether they helped

Also consider the environment. Carbon monoxide is an odorless, colorless gas that can cause headache, dizziness, weakness, nausea, chest pain, and confusion. If several people in the same building develop symptoms, a fuel-burning appliance or generator has been used nearby, or a carbon monoxide alarm sounds, move into fresh air and seek emergency help. The CDC explains carbon monoxide symptoms and prevention.

How Back-of-Head Pain Is Evaluated

A primary care clinician can assess most new or recurring headaches. The evaluation typically includes questions about the pain pattern, medications, medical history, injuries, and associated symptoms, followed by physical and neurological examinations. Depending on the findings, referral to a neurologist, headache specialist, physical therapist, dentist, or other professional may be appropriate.

CT or MRI imaging is not required for every headache. A clinician may order imaging when the history or examination suggests bleeding, injury, infection, a structural problem, or another secondary cause. Imaging is only one part of the evaluation, and readers can learn more about conditions that might not show up on an MRI.

When to Seek Care

Call 911 or seek emergency care for a headache that reaches maximum intensity suddenly, feels like the worst headache of your life, or occurs with:

Weakness, numbness, facial drooping, confusion, or difficulty speaking
Fainting, a seizure, severe balance problems, or loss of consciousness
Double vision, sudden loss of vision, or new trouble walking
Fever and a stiff neck
Repeated vomiting or difficulty breathing
A significant head or neck injury

Arrange a medical appointment for pain that is new, increasingly frequent, progressively worsening, different from your usual headaches, or interfering with work or sleep. Evaluation is also important for a new persistent headache after age 50, during pregnancy or after delivery, or in someone with cancer or a weakened immune system.

Most pain in the head’s back region is not caused by an emergency, but symptoms and timing matter. Paying attention to the pain’s quality, triggers, and accompanying signs can help you decide whether simple measures are reasonable or professional evaluation is needed.