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Headache at the back of the head

Also called: Occipital headache, back-of-head headache, cervicogenic headache

A headache at the back of the head is often a tension headache from tight neck and shoulder muscles, poor posture, or arthritis in the neck. Occipital neuralgia causes shooting pain from the base of the skull. A sudden severe headache at the back of the head, or with a stiff neck and fever, needs 911.

Common causesTension headache, neck strain, poor posture, occipital neuralgia
Usually serious?Usually not
Get checked ifIt's sudden and severe, or with a stiff neck and fever
If you think it's an emergency, call 911.Thinking about suicide? Call or text 988.

Overview

Tension in the neck and upper back can cause a dull, tight headache at the back of the head. Long hours at a desk, looking down at a phone, and poor sleep position are common triggers.

Arthritis or problems in the neck can cause headaches that start in the neck (cervicogenic). Occipital neuralgia causes sharp, shooting, or electric pain from the base of the skull up the back of the head. Very high blood pressure can cause headaches here too.

When to get medical care

Call 911Sudden, severe 'worst headache of your life.' Headache with weakness, numbness, trouble speaking, vision loss, or confusion. Headache with fever and a stiff neck. Headache after a head injury. A sudden, severe headache at the back of the head during exercise or sex.
Get care todayA headache with a very high blood pressure reading. A headache with neck pain after an injury.
See a doctor soonHeadaches that keep coming back. Shooting pain at the base of the skull. Neck pain with numbness or weakness in the arms.

Causes

Common causes include tension headache, neck muscle strain, poor posture, and arthritis of the neck. Other causes include occipital neuralgia, migraine, very high blood pressure, and, rarely, bleeding in the brain, meningitis, or problems where the skull meets the spine.

OwieClear has pages on 4 conditions that can cause headache at the back of the head. Each shows how soon to get care.

Common causes

  • Tension headacheOften treated at home

    The most common headache type, often felt as a tight band around the head and linked to stress or posture.

  • Neck-related headache (cervicogenic)See a doctor if it doesn't get better

    Pain that starts in the neck and spreads to the back of the head, often on one side.

  • Occipital neuralgiaSee a doctor if it doesn't get better

    Irritation of the nerves at the base of the skull.

  • Chiari malformationSee a doctor if it doesn't get better

    Part of the brain at the back of the skull pushes down into the spinal canal.

What you can do at home

  • Use heat on your neck and shoulders.
  • Gently stretch and massage your neck.
  • Improve posture: raise screens to eye level and take breaks.
  • Use a supportive pillow.
  • Manage stress and get regular sleep.

Medicines

Acetaminophen, ibuprofen, or naproxen can help. A provider may suggest physical therapy, muscle relaxants, or a nerve block for occipital neuralgia.

At the doctor

The provider will look at your neck and headache pattern.

Questions you may be asked

  • Where the pain starts and spreads
  • Neck stiffness or injury
  • Posture and work setup
  • Blood pressure
  • Warning signs

The exam

A physical exam of the neck, nerves, and blood pressure.

Tests

  • Usually no tests
  • Neck X-rays or MRI if needed
  • Brain imaging for warning signs

Prevention

You can reduce these headaches.

  • Keep good posture
  • Take breaks from screens
  • Stretch your neck
  • Exercise regularly

Check your symptoms

Most symptoms have more than one possible cause. The symptom checker looks at all of your symptoms together, plus your age, and shows how soon to get care.

Start the symptom checker

Sources

Last updated 2026-11-13.