introduction

Almost everyone suffers from headaches more or less often in their life.
As with all headaches, including headaches in the back of the head, the causes are mostly harmless in nature and are rarely due to a dangerous or malignant disease.

causes

Tension

Tension in the neck or jaw muscles is the most common cause of pain in the back of the head and headaches in general. While jaw tension is usually triggered by grinding teeth at night, the reasons for neck tension are most likely to be one-sided strain on the back and neck or a lack of exercise due to predominantly sedentary work.

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But why does tension lead to headaches at all? This mechanism is due to the fact that the tension stimulates nerve tracts that transmit pain signals to the brain. The most effective remedy for tension in the jaw muscles is to use a bite guard at night. Neck tension is best relieved through exercise, relaxation exercises and the application of heat.

Read more on the topic: Tension in the neck

Psychosomatic causes

In principle, psychologically triggered pain or other complaints can occur in practically every part of the body. The head, and especially the back of the head, is particularly often affected. Psychosomatic means that complaints are triggered by psychological stress.

If the pain persists for a longer period of several weeks, you should contact a family doctor or a neurologist. He or she can discuss whether the pain is more pronounced in certain situations and whether there are other symptoms that could suggest a certain cause of the pain.

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Read more on this topic: Psychosomatics

Cervical spine syndrome

Another possible cause of pain in the back of the head is cervical vertebra syndrome (Cervicocephalgia). This refers to pain emanating from the cervical spine and radiating to the head. Radiation in the jaw or face is also possible. In addition, there may be fewer problems with sight, hearing or swallowing. However, cervicocephalgia is not a diagnosis, just a description of the symptoms.

The causes can be herniated discs of the cervical spine, deforming diseases of the spine such as spondylosis, spondylarthrosis, uncovertebral arthrosis or muscle wasting (atrophy) of the neck muscles. A neuroma of the supplying nerves is also conceivable, a benign tumor of the cells that act as myelin sheaths surrounding the nerve processes.

Also read: Cervical spine syndrome

Occipital neuralgia

Another possible cause of back headache is the so-called occipital neuralgia, which is sometimes also referred to as occipital syndrome. The occipital lobe is the back part of the cerebrum. With this disease, the pain is actually limited to the back of the head. The cause is chronic nerve pain, which manifests itself in primarily unilateral pain on the back of the head and the upper neck. The pain can also follow the course of the affected nerve and thus radiate towards the eye.

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Situational pain in the back of the head

Pain to the touch

If the pain in the back of the head occurs only or predominantly when touched, a bruise is the most likely cause. As a rule, the back of the headache that only occurs when you touch it is not a cause for concern and will go away on its own after a few days.

Cooling or the application of pain relievers and anti-inflammatory ointments can provide relief and speed up the healing process. However, if the pain is still present and only intensifies when touched, a doctor should be consulted. This can, for example with the help of a CT scan, rule out more serious consequences such as bleeding inside the skull.

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Pain when lying down

If the pain in the back of the head occurs exclusively or predominantly when lying down, you should specifically test whether this is only the case when lying on your back or also when lying on your side.
The former is most likely to indicate that the back of the head is bruised - for example, from a fall or the back of the head bumping into a solid object - and the pain when lying down is caused simply by the pressure on the bruise. If the pain persists regardless of the lying position and disappears after getting up, the cause is most likely to be found in the circulatory system. If the symptoms do not improve noticeably within one to two weeks, it is therefore advisable to see a doctor.

Back of the head pain during a cold with cough

Often, pain in the back of the head is associated with a cold and cough. Most of the pain is then due to the fact that the flu infection has weakened the body's water balance - in these cases the usual home remedies for flu help: drink a lot, dress warmly and, if necessary, take pain relievers such as ibuprofen or paracetamol.

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Localization pain

Pain in the bone

The skull bone is sometimes involved in the development of pain in the back of the head if the complaint is based on an accident (trauma). Usually this consists of falling on the back of the head or bumping the back of the head against a solid surface. Accidents like this can be tricky: If the victim suffers a laceration, it usually bleeds very heavily and alarms the victim and his surroundings, so that a medical assessment is usually carried out immediately.

If the back of the head does not bleed, however, that does not mean the unqualified all-clear: Sometimes hard knocks cause fractures of the skull bones or bleeding within the skull, which are not visible from the outside, but all the more dangerous. If the fall or bump was very violent, or if the person affected feels any other symptoms (e.g. nausea, visual disturbances) in addition to the pain, a hospital should be visited as soon as possible! There, the bones can be examined for fractures with a CT scan and bleeding within the skull can be excluded at the same time.

Pain in the back of the head and neck

In many cases, pain in the back of the head is associated with neck pain. This is because tension in the neck muscles is the most common cause of back headaches. Particularly at risk of neck tension are people with one-sided physical exertion or predominantly sedentary work (especially office jobs). But inadequate sleeping conditions (poor quality mattress, unsuitable pillow) can also cause tension in the neck muscles.

Once the tension is there, it rarely disappears on its own. Without corresponding improvements in the environmental and / or working conditions, the pain often remains permanent and can sometimes limit the quality of life of those affected. It is therefore essential to improve the environmental conditions in the sense of eliminating the causes.

That means: in the office change your sitting position more often and get up more often for a few minutes; Get comfortable, adequate mattresses and pillows and avoid one-sided strain on the back and neck if possible (heavy handbags are also risk factors!). In addition, warmth (e.g. in the form of cherry stone pillows), movement and relaxation exercises and massages help.

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In very rare cases, meningitis (inflammation of the meninges) can cause the combination of pain in the back of the head and neck pain. Most of those affected then develop an additional fever and, in addition to neck pain, also experience increasing neck stiffness. Since this illness is an emergency, you should act immediately and seek medical help!

You may also be interested in this topic: Active treatment concept for neck pain

Unilateral pain in the back of the head

If the pain in the back of the head is predominantly or exclusively on one side, this can have various causes. The most obvious explanation is that you fell or hit that side of the head. If you cannot remember such a situation, it is most likely that one-sided strain has led to one-sided tension in the neck muscles, which now manifests itself in the form of back headaches.

In rare cases, left or right side pain in the back of the head is also due to mastoiditis (inflammation in the mastoid process of the temporal bone) that has developed on the floor of an otitis media. Then there are usually other cold symptoms in addition to the pain. Theoretically, of course, a tumor can explain the unilateral back of the headache, but you should be aware that this is only the case with very few people affected.

Back of head pain with other symptoms

Pain in the back of the head with dizziness

If pain in the back of the head is accompanied by dizziness, it is usually due to a harmless cause. In the vast majority of cases, tension in the neck muscles is the trigger for the symptoms. Then the home remedies and conversion measures described above usually help. Although it is theoretically possible that a tumor is behind the combination of occipital headache and dizziness, this is only the case with very few people affected - so there is no reason for alarm!

Only if the dizziness has persisted for a longer period of at least one to two weeks should you have a medical examination to be absolutely sure.

Read more on the topic: Headache and dizziness

Back of head pain with nausea

If the pain in the back of the head is accompanied by nausea, the cause is usually to be found in the neurological spectrum. The additional occurrence of fever and / or stiff neck suggests meningitis (meningitis) and should lead to immediate hospitalization! In this disease, the symptoms develop relatively quickly within a few hours.

If, on the other hand, a gradual increase in symptoms can be felt over a longer period of several weeks, it is more likely that the reason is increased intracranial pressure. In very rare cases this can also be triggered by a tumor, but usually a far more harmless cause is found. If you have recurring headaches with nausea, you should also think of a migraine. In this case, you should consult a neurologist to confirm the suspicion and begin appropriate drug therapy.

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Read more on the topic: Headache with nausea - what's behind it?

Other causes

A distinction is made between a primary headache, which includes migraines and cluster headaches.

Secondary headaches are caused by another illness or a specific trigger, such as trauma, a brain tumor, or bleeding in the brain. Furthermore, a wide variety of drug classes can cause headaches as a side effect.

Subarachnoid hemorrhage

An important differential diagnosis is subarachnoid hemorrhage. The arachnoid (Spider skin) is the outer of the two inner, soft meninges (Leptomeninx). A hemorrhage into the subarachnoid space thus pours into the space between the meninges and the brain, with the arachnoid being close to the brain. The cause of this arterial bleeding is usually the rupture of an aneurysm. As with post-coital headache, pulsating headaches occur, which usually start very suddenly and have a very strong intensity, so that they are also referred to as annihilation headaches.

Furthermore, neck pain and stiff neck occur (Meningism) and there may be a short-term, temporary loss of consciousness. Symptoms that reinforce the suspicion of subarachnoid hemorrhage are also signs of intracranial pressure, vomiting, a drop in blood pressure, and a change in breathing and pulse rates.

In the long term, this can result in severe neurological failures, and subarachnoid hemorrhage ultimately represents a special form of stroke. In this respect, subarachnoid hemorrhage is always a medical emergency that requires immediate treatment.

Pain in the back of the head as an indication of a tumor?

Many headache patients worry that a tumor may be behind their symptoms. Only in an extremely small proportion of the cases actually indicates a serious illness. A tumor seems most likely to be a possible cause if the pain in the back of the head persists for a long period of time and is particularly severe at night. In addition to the pain, those affected usually experience other symptoms, such as visual disturbances. If this is the case with you, you should consult a doctor to be sure to clarify the suspicion.

Read more on the topic: Tumor diseases

therapy

The creation of better working and sleeping conditions as well as the fight against tension by means of movement and relaxation exercises is a good way of relieving the back of the headache when tension is the cause of the pain.
Massages can also help to loosen up the muscles. Warmth promotes blood circulation and thus also counteracts tension. So treat your neck to a hot water bottle or a cherry stone pillow, it will thank you for it!

You might also be interested in this topic: Headache therapy

Duration

A general statement on the duration of pain in the back of the head cannot be made due to the many possible causes. If, as in most cases, the pain is based on muscular tension in the neck or jaw area, an improvement often only occurs when the cause has been recognized and an appropriate response has been made (e.g. setting a better sitting position in the office for neck tension, nighttime use of a Bite guard for jaw bracing).

If an accident (usually a fall on the back of the head) can be identified as the cause, the symptoms usually last between a few days and two weeks. At this point at the latest, it is advisable to consult a doctor.


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