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Headache at the back of head or headache at the top of the head is a common problem, but it is certainly not a normal feeling to experience. Sufferers feel a dull, heavy and aching feeling at the back of the skull and into the top of the neck. The muscles can feel tight, sore and inflamed. The head can feel heavy and this makes concentration a challenge. READ ON to find out WHY this happens, HOW to get rid of it and HOW you can prevent this happening in the future.
(There’s also a diagram to help differentiate between headaches and migraines!)
Author: I have been fortunate enough to not suffer from headaches, but I have met and helped thousands of patients, many of which suffering from debilitating headaches for decades. They can make work, socialising and family time near impossible. Headaches are no joke and should NOT be taken lightly!
What are Headaches?
Headaches are any pain or aches that people feel in their head (duh!) or upper neck. These can be mild to severe and can last seconds to weeks. The most common causes:
- spinal mis-alignments
- pinched nerves
- improper blood flow
- muscular tension
Headaches can be common and triggers are dependent on activities of your daily life; especially dealing with stress and emotional issues
Everyone knows somebody who has had a headache when they have lots of work to do, study too hard or were having problems with family or friends. This is especially prevalent in developed cities where the demands and levels of competition are high, like Singapore!
Are there different types of Headaches?
There are more than 15 known types of headaches, but they can be classified as:
- Primary – such as migraine, tension, cervicogenic or cluster
- Secondary – a symptom of an underlying issue, such as sinus problems
- Other – Cranial neuralgias, facial pain and other headaches
For this article the main focus will be on the Primary headache types. For each we will explain the differences so you can make the best choices for your condition, as some have a crossover of symptoms including headache at the back of the head.
Which type of headache do I have?
Migraines
Migraines can be caused by neurological changes. There are links to hormone changes, lack of sleep and stress.
Why? Certain foods (such as chocolate, red wine, caffeine, cheese) may trigger migraines. However, this is less of a problem in the foods and more in the body, they just trigger the underlying nerve problem. Migraines have two types, one is where people feel a warning that they will get a migraine (known as aura), the other is without warning (non-aura).
Symptoms? Patients with migraines usually experience severe pain on one side of the head, nausea, sensitivity to sound/light and pain behind the eyes. Migraines occur more often in women (approximately 75%) and prevent normal tasks and activities.
Tension headaches
These are the MOST COMMON types of headaches. It ranges from mild to fairly disabling. It is commonly seen in stress, depression and anxiety cases. If it is the first headache ever of its type and extreme in pain it is important to rule out other pathologies; such as stroke, haemorrhage or meningitis.
Why?
These can be due to nerve irritation or muscle tightness, particularly around the neck and shoulders. They are seen commonly with psychological triggers, such as stress or anxiety. May be triggered by lack of sleep or other causes for increased fatigue.
Symptoms?
This is pain that usually starts in the back of the head and upper neck, sometimes described as a band-like pressure encircling the head. This may be be felt near the temples, forehead, along the neck and into the shoulders. They are usually less disabling than migraines, but can make daily tasks very difficult. However, this can also result in shoulder pain and other problems in the arm and hand, such as tingling, numbness, weakness and muscle cramps.
Cervicogenic headaches
These are headaches which are DIRECTLY linked to the nerves in the neck being pinched. Mis-alignments in the bones of your neck compress the nerves. This is especially at the top of your neck where the spine meets the skull, at the Upper Cervical Region (also known as the Cranio-cervical Junction). This region contains your brain stem, mis-alignments (termed Subluxations) in the Upper Cervical region will press on the nerves of the brain stem, disrupting normal function.
Why?
This can be caused by: over exertion, stress, bad posture, depression, looking down at phones, sleeping position, or injuries and accidents. Much like migraines, tension headaches are more common in women.
Symptoms?
This can start as headache at the back of the head or neck, then spread to the rest of the head unilaterally. The headache may be felt at the temples and even in to the ear. Pain may be made worse by movements of the neck. Symptoms can spread to your head, face, neck, shoulders and down your arms to your hands. The muscles may be tense and sore. Other symptoms may accompany, such as: vomiting, nausea, dizziness, blurred vision or difficulty swallowing. This may appear similar to migraines.
Cluster Headaches
What? These are much more painful and EXTREME than migraines, cervicogenic or tension headaches. Cluster headaches are named this way because they usually appear in “clusters” of time, usually a week or so, then not happening again for long periods. When active they appear at the same time of the day, and often wake you in the night. These are far RARER than tension headaches or migraines.
Why?
The condition is a neurological disorder with an uncertain cause, but it is theorised this may be due to a change in brain function at the hypothalamus. It is more common in men and for sufferers to be smokers. Doctors note that correcting mis-alignments in the neck helps to control and improve the condition.
Symptoms?
Cluster headaches are EXCRUCIATING headache attacks. They are felt on one side of the head, around the eye and in the temple, and can feel stabbing in nature. This is significantly worse than a migraine or tension headache, being reported as one of the most painful known conditions. Other symptoms can include: sweating, nausea, restlessness, sensitivity to light and sound, runny nose, exhaustion, anxiety and depression.
Headache vs Migraine?
The symptoms for cervicogenic headaches and migraines are particularly similar as they both have proven neurological origins. Both can be unilateral (one sided) and have nausea, vomiting and effects on eye-site. The ways to differentiate them are:
 Migraines can switch sides |
Migraines are more commonly triggered by foods, weather or medications |
Migraines can start from hormonal, inflammation, hereditary or other sources |
 Cervicogenic stay on one side |
Cervicogenic can arise from neck movements |
Cervicogenic commonly start after a physical injury to the neck, such as whiplash |
(Read more about The Causes of Neck Problems, here)
WHat about HEADACHE AT THE top OF THE HEAD?
Headache at the top of the head may be less common than a headache at the back of the head but it still occurs and, of course, is still debilitating. Headache at the top of the head is more likely to be due to tension headaches than cervicogenic headaches.
Headache at the top of head will feel tight and constructive, with pressure like a tight band has been placed around the head. This may then radiate to the back of the head and neck. In some cases this may also be linked to an injury (such as something hitting that part of the head), tension in the muscle of the skull or even problems with the jaw, such as TMD (temperomandibular disorder).
The muscles surrounding and controlling the jaw tense in reaction to a problem at the jaw or its joints. This then can create pain across the top of the head. This is usually linked to a problem in the top of the neck, unless there has been a direct injury to the jaw itself.
Much like the other types of headache listed above, the origin is usually linked to the nerves originating in the upper neck.
In some cases the headache at the top of the head may be caused by migraine, especially if combined with pain at the side of the head or other associated symptoms (such as aura or nausea).
Note: while very rare, headache at the top of head can be linked to vascular causes, especially if it is the worst headache ever experienced (sometimes referred to as a ‘thunderclap’ headache) and/or you don’t usually experience headaches. In this case please seek medical attention to rule out serious pathologies.
WHAT ABOUT: HEADACHE ON THE RIGHT SIDE OF HEAD OR HEADACHE ON THE LEFT SIDE OF HEAD?
Headache on the left side of head or headaches on the right side of head are most commonly due to cervicogenic headache or migraine headaches.
To determine the type it will be helpful to note:
- If it stays on one side or switches
- Is it triggered by neck movements or is it triggered by food/weather/medication
- How does it start?
See the above table for ‘Headaches vs Migraine’ to help determine which is the cause for headache on the left or right side of head.
WHAT IF I GET headache when wake up?
Headache when waking up can be a common experience. Things may feel fine in the evening, but by the morning the neck is stiff and a headache develops. This may even cause symptoms into the jaw, shoulder, arm or fingers.
The truth is the headache when you wake up is not due to solely one nights sleep. It is an accumulation of poor sleeping position, posture, old injuries, stress, over exertion and other factors over time. It may seem logical to blame a mattress or pillow, but it is due to a combination of factors which have degraded the health of the neck over time.
In these instances the headache after waking up is a result of the straw that broke the camels back, with months of abuse /injury (non-symptomatic) eventually effecting the nerves which feel pain (symptomatic).
So, why pain at the back of the head?
Based on the above types of headaches, it is most likely to be a tension or cervicogenic headache. In some instances it may be a migraine, but this more commonly affects one side of the head and has other neurological symptoms.
The causative triggers may be linked to stress, accidents or injuries to the neck
The reason the headache at the back of the head and top of the neck is so common for many headache forms is the density of nerves in this area. The nerves carry messages from the brain to the body and visa versa. When the nerves leave the brain they pass through the upper neck and spread throughout the body. Therefore, the concentration is highest at this point.
Think of the top of the neck like a fire hydrant. The water pressure at a fire hydrant is very high so the water can pass down the hose. The concentration of nerves is very high at the top of the neck because they pass to the rest of the body.
Any disruption to them will affect the local area FIRST, causing headache at the back of the head. This then effects the rest of the body, potentially causing other health problems in the back, organs or legs.
How do do I relieve it?
Currently the most common “treatments” for headache at the back of the head address the SYMPTOMS but not the CAUSE.
The most common are:
- Medication – numbs your body but doesn’t treat the cause, resulting in your body doing more damage and more and more medications needed in the long term.
- Botulinum toxin – injections in to the painful areas, this can be helpful in extreme cases for short term relief.
- Electrical stimulation – this uses shock therapy to the nerves to overstimulate them.
- Massage/stretching – this loosens your muscles which may tight. However, the muscles are in spasm to HELP protect your body, therefore relaxing them can sometimes worsen symptoms.
- Rest – allows your body to heal on its own, but doesn’t deal with the problem in your nerve system so it recurs when triggered again.
Natural remedies for Headaches
Heat therapy
Heat therapy helps to relax the muscles that have tightened without aggressive massage. This promotes more blood flow into the area.
Meditation
Meditation can be particularly helpful if stress is one of the main causes and triggers. There may still need to be intervention from a doctor, but the meditation can help to increase the effectiveness and prevent recurrence.
Behavioural Therapy
Behavioural therapy helps address the stress or thought pattern which led to the headaches. This can be facilitated by a therapist or counsellor. Changing the reactions to a situation change the future effects.
Supplementation
Supplementing with magnesium or ginger have shown improvements in the short term or to control headaches
Read about More Ways to Relieve Headaches and Migraines, here.
Is there a long term scientific solution?
Headaches have been PROVEN through research to have improved outcomes when managed with Chiropractic care, especially in practices that focus on Upper Cervical Care. At Vitality Chiropractic Centres we specialise in headaches and migraines, helping our patients to find a long term solution without medication! Every patient has a Consultation to find out EXACTLY what is causing their problem and how the Doctor can help. This includes:
- A detailed history
- Physical examination
- Nerve tests using state of the art equipment
- Specialised Biomechanical x-rays to specifically analyse your condition (the only practice to take these in Singapore)
Headaches are commonly due to mis-alignments (also known as Subluxations) in the bones of your neck, which irritate and block your nerves. Once these Subluxations are removed the body heals naturally and PAIN STOPS. Our Doctors are highly trained, specialising in analysing, diagnosing and managing Subluxations in the neck which cause headaches.
They are the first in Singapore that have attained these post-graduate qualifications in Upper Cervical Care. Our patients have great outcomes, whether they complain of 1 week or 20 years of headaches or migraines!
Once your nerve system is clear from interference you will be able to return to normal activities, be less apprehensive about your actions and take on new challenges! Your doctor will also ensure to do check-ups in the future to make sure you stay as healthy as possible and stay headache free.
If you have any questions or need help finding the Singapore Chiropractic centre to help your headache at the back of your head, then contact us via 8438 9550 or help@vitalitychiropracticcentres.com, or comment on Facebook or Instagram.
Since 2013, Upper Cervical Chiropractor, Dr. Shaan Rai helped patients achieve greater health, relocating to Singapore in 2016 and founding Vitality Chiropractic Centres. He has an impressive track record in providing relief and solutions for people who experience nerve system problems, such as headaches, migraines, dizziness, vertigo or neurological conditions.
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