Headache in the back of the head: Where it comes from and how to relieve it

Causes of tension headaches tend to include:

Treatment

If you’re experiencing a tension-type headache, you may feel mild to moderate pain in the back of your head. Most tension or stress headaches can be treated at home. Rest and over-the-counter anti-inflammatory medications such as ibuprofen and acetaminophen (aspirin shouldn’t be taken by teens under the age of 15) may be enough to provide pain relief and make a tension headache go away. In some cases, you might want to use an ice pack or a muscle relaxant to release the tension. Caffeine can be helpful, too.

Gentle yoga can also be an effective way to treat tension headaches. With its focus on deep breathing, relaxation, and stretching of the muscles, this type of treatment can release the tension in your head and neck stiffness that may cause you to feel pain. There are many yoga sequences specifically focused on neck tension that can provide immediate relief from headaches. Plus, once you’ve gone through a couple of these yoga stretches, you may have a tool you can come back to time and again. Often, these types of stretches are very simple and can be done anywhere, anytime, so you may find a way to handle tension headaches even if you’re at school or work.

Prevention

To prevent tension headaches, it can be important to have healthy ways to handle stress. Engaging with your creativity by drawing, painting, writing, or journaling can be a productive way to decrease stress. You can also spend time with friends, family, and pets. Exercise, even if just a short walk around the block, can also lower stress levels. Hobbies like hiking, fishing, and martial arts are other options you can partake in for stress relief. 

Positive nutritional choices can also help ensure the health of your brain. If you struggle to maintain healthy stress levels and frequently find yourself feeling overwhelmed, it may be wise to speak with a therapist. A therapist can help you get to the root of the issue and give you suggestions for stress management and coping skills. Seeing a therapist can help you in many areas of life.

Living a healthy lifestyle can help quite a bit with most headaches as well. A healthy lifestyle involves fueling your body with nutritious food, drinking plenty of water, exercising daily, and getting sufficient sleep each night. Relaxation techniques and biofeedback can be effective in preventing tension or stress headaches, too. Finally, since eye strain from looking at screens can lead to tension headaches, be sure to look away from screens every 20 minutes or even take a longer break from screen time if possible.

What if my head hurts when I lay down?

Pain in the back of your head that worsens when you lay down can be caused by cluster headaches or headaches that occur in frequent clusters. Cluster headaches are thought to be caused by changes in the blood vessels like swelling or dilation or an increase in blood pressure. A cluster headache is considered a primary headache, as the headache is not caused by underlying headache disorders.

Here are some of the other symptoms of cluster headaches:

• Sharp, burning pain
• Excessive tearing
• Droopy eyelids
• Restlessness
• Nausea
• Stuffy nose
• Sensitivity to light and sound
• Pain on one side of the head or around one eye

A doctor is often needed for the treatment of cluster headaches because they might need stronger pain medication to heal rather than simpler over-the-counter solutions. Typical treatment for cluster headaches includes triptans, local anesthetics, and octreotide. Prevention often involves melatonin, nerve blockers, and corticosteroids. Always speak to your doctor before beginning or ceasing the use of any medications.

Migraines are another type of primary headache that has many of the same symptoms as cluster headaches. The difference between the two is that cluster headaches typically come on more quickly than migraines, with an intense pain that comes on fast and strong, while migraines generally consist of a more continuous, throbbing pain. A migraine may also be more intense, causing severe symptoms such as confusion, blurred vision, and mood changes. The American Migraine Foundation offers help in finding doctors to treat symptoms, as well as support groups for individuals who experience migraines, and their families.

Other types of headaches

Another type of headache called cervicogenic headache can be caused by sudden neck movements, or holding the neck in one position for too long. Cervicogenic headaches can have many of the same symptoms as migraines and may require more intensive steps like nerve blockers, work with a physical therapist, or very rarely a medical procedure to prevent the nerves from being squeezed.

If your head hurts, accompanied by pain in the back or neck and dizziness, and is relieved by laying down, you may be experiencing spontaneous intracranial hypotension. Also, known as a low-pressure headache, it is a secondary headache caused by below-normal levels of cerebrospinal fluid. This can be caused by conditions like spinal fluid leaks due to spinal surgery, epidurals, or head injury. These types of headaches typically resolve themselves on their own.

Some other, more serious types of secondary headaches to look out for include occipital neuralgia or occipital nerve headaches, medication overuse headaches, sinus headaches, migraine headaches, and headaches originating in the spinal cord. These headaches can have neurological symptoms and severe pain behind the eyes and like cervicogenic headaches, may need physical therapy.

For more information on primary and secondary headaches, you can consult the Complete Headache Chart. This is a resource offered by the National Headache Foundation that offers symptoms, treatments, and prevention for every kind of headache.

Do I need to see a doctor?

For most tension headaches and headaches in general, it’s not necessary to see a doctor. However, in the following situations, you should speak to a medical professional, especially if you have an underlying health condition.

• You have chronic headaches (headaches occur more than 15 times per month for at least three months)
• Your headaches are frequent or severe
• Your headaches are negatively impacting your everyday life
• Over-the-counter solutions don’t help your headaches

Doctors may prescribe antidepressants or NSAIDs like indomethacin, ketoprofen, ketorolac, or naproxen for tension headaches that aren't relieved by over-the-counter pain relievers. Of course, always speak with your doctor before starting any new medications, and be sure to discuss any potential side effects.

You should call 911 or visit the emergency room if you experience the following symptoms, as they may be referred pain or signs of a serious illness:

• You have a headache accompanied by weakness or numbness
• Your headache makes it difficult to see, speak, or think clearly
• Your headache causes your face to droop
• You experience a very sudden and severe headache
• You have a headache after experiencing a blow to the head, whiplash injury, or another injury in the head or neck area

Online therapy with BetterHelp

If you’re plagued by tension headaches resulting from emotional stress, it may be beneficial to speak with a therapist. BetterHelp is an online counseling platform that can match you with a certified therapist who specializes in the areas you need extra support. You can communicate with them through messages, phone calls, or video sessions. A therapist, whether in person or online, can help you work through your stress and find effective ways to cope with and manage it.

The effectiveness of online therapy

Studies have proven that online cognitive behavioral therapy can be effective in treating anxiety and depression. If you’re living with one of these mental health conditions, you might be more prone to getting tension headaches. Cognitive behavioral therapy (CBT) is a type of therapy that teaches people to reframe their negative thought patterns into more helpful ways of thinking.