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I have a cold with headache in back of head?

Have a headache in back of head

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1. Headache Back of Head

On average 5400 people enter "headache back of head" into Google each month. So here's the causes of pain in the back of the head.

Most of these are not serious.

The most common of these is a pain referred from the joints of the upper spine. This is called cervicogenic headache (cervic = neck, genic = caused by).

The classic cervicogenic headache causes a pain in the back of the head - on one side only. The pain can spread up the back of the head and round the side towards the ear or over the top into the forehead.

Most people with cervicogenic headache will have previously injured their neck (a whiplash injury is typical) or will have restricted neck movements due to "wear and tear" of the joints of the upper neck bones.

Cervicogenic headache is very common - as many as 4% of adults will have this pain

Here's a full list of causes of a headache located in the back of head starting with the least serious:

1. Cervicogenic Headache
2. Occipital Neuralgia
3. Severe, sharp "headache back of head" that spread up to the top of head or into the eye on the same side. Nerve block or Gabapentin worth trying. Most people who are diagnosed with occipital neuralgia will actually be suffering from cervicogenic headache. Retropharyngeal Tendinitis
4. This pain is severe, onset over about 1-2 days and is associated with pain on swallowing. ESR may be slightly elevated. treat with NSAIDS e.g. Diclofenac or Indomethacin Ice-pick Headache
About 35% of all people will get these brief intense pains in the head lasting a few seconds (This information is from a large Norwegian Study called the Vaga Study). In a small number of people, these ice-pick pains are located, exclusively, in the neck or very back of the head. It can be very difficult to tell the difference between cervicogenic headache and ice-pick pains. Usually ice-pick pains can occur anywhere in the head, whereas cervicogenic headache are locked to one side of the head only.

5. Lateral Atlanto-axial joint disease. Rheumatoid arthritis is the most common serious cause of this problem.

6. Neck-tongue syndrome
This is an unusual pain syndrome. Rotation of the neck produces sensory disturbance in the tongue, some patients will get a spasm of tongue muscle. There are nerve fibres which run in the nerve to the tongue (hypoglossal nerve) which join with fibres from the upper neck (C2 nerve), so pain from the neck can produce symptoms in the tongue. The more serious causes include:

7. Temporal Arteritis / Giant Cell arteritis
Please recall that the occipital arteries are frequently involved in temporal arteritis, and as they lie right next to the greater occipital nerve, temporal arteritis can be confused with occipital neuralgia (I've done it, but the penny dropped at follow-up and a good recovery ensued on prednisolone!). About 30 people per 100,000 will get temporal arteritis in any given year.

8. Vertebral Artery Dissection
This may present with a sudden severe "headache back of head", but is even more rare than arteritis at about 5 people per 100,000 each year with this rare condition.

9. Chiari Malformation
The low lying cerebellar tonsils could stretch the upper cervical nerve roots and contribute to pain in the back of the head. The classic pain of Chiari Malformation is provoked by coughing.

10. Low pressure headache - Intracranial Hypotension
Pain in this low pressure headache can be experienced anywhere, but would be worse with upright posture in classic cases. Can be relieved by epidural blood patch procedure. The typical pain of intracranial hypotension is in the side of the head.

11. Subarachnoid haemorrhage may cause a thunderclap headache pain of sudden onset in the back of the head.



Treatment for Headache in Back of Head
The treatment for this location of headache will depend on the cause.

By far the most common cause is cervicogenic headache.

Non-steroidal anti-inflammatory tablets are probably best. If a short course of these does not help, then treatment from a physiotherapist can relieve the pain.

If Non-steroidals and physiotherapy do not provide relief, then a facet joint injection by a pain specialist may give longer term relief.

Occipital nerve block can give temporary relief in some cases. I have used thes in people who have been admitted to hospital with severe cervicogenic headache in an attempt to provide temporary relief - with some degree of success (5ml of 1% lidocaine).