Pain in the back of the head
Pain in the back of the head is observed in migraine, vertebrobasillary insufficiency, arterial hypertension, cerebral atherosclerosis, meningitis, encephalitis, occipital neuralgia, head and neck injuries, some diseases of the muscles and spine. It can be blunt, acute, local, diffuse, pressing, burning, pulsating. The cause of the symptom is established on the basis of complaints, examination data, additional instrumental and laboratory techniques. Treatment – analgesics, antibiotics, NSAIDs, hypotensive, hypolipidemic agents, neuroprotectors, physiotherapy, surgery.
Why does the back of my head hurt
Migraine
Vascular diseases
Inflammatory processes in the central nervous system
Traumatic injuries
Defeat of the cervical spine
Occipital neuralgia
Muscle damage
Heat and sunstroke
Other reasons
Diagnostics
Treatment
Pre-hospital care
Conservative therapy
Surgical treatment
Prices for treatment
Why does the back of my head hurt
Migraine
With migraines, there is more often a throbbing pain in the temple or forehead area, but in a number of patients, the attack begins with painful sensations in the back of the head, which then spread to half of the head. Nausea, loss of appetite, photophobia, intolerance to loud sounds, and an increase in the symptom against the background of any physical activity are characteristic. After the episode ends, pallor, weakness, and yawning are noted.
Basilar migraine is manifested by regular paroxysms that occur every few weeks or months. It is preceded by an expanded aura lasting from 5 minutes to 1 hour, including tinnitus, dizziness, ataxia, double vision, dysarthria, and a number of other symptoms. After the aura, there is a sharp, usually unilateral pain in the back of the head, which in 30% of patients is combined with nausea, vomiting, sound and light phobia.
Vascular diseases
Headache with arterial hypertension is dull, pressing or bursting, more often localized in the back of the head. It is complemented by dizziness, heaviness, pulsation, tinnitus. Lethargy, weakness, nausea, palpitations are noted. Along with primary hypertension , the manifestation is characteristic of symptomatic hypertension against the background of the following pathological processes:
Kidney diseases: pyelonephritis, glomerulonephritis, hydronephrosis, nephrosclerosis, amyloidosis, polycystic, nephroptosis, malformations.
Renovascular pathologies: aneurysms, dysplasia, thrombosis, atherosclerosis of renal vessels, vasculitis.
CNS lesions: intracerebral neoplasia, TBI, stroke, encephalitis, meningitis.
Endocrine disorders: Conn’s syndrome, pheochromocytoma, thyrotoxicosis, Itsenko-Cushing’s disease, acromegaly.
Hemodynamic disorders: stenosis of the carotid and vertebrobasilar arteries, sclerosis and coarctation of the aorta, aortic insufficiency.
Side effects of medications: taking oral contraceptives, indomethacin, levothyroxine, glucocorticoids, mineralocorticoids.
In cerebral atherosclerosis, pain is detected at the initial stage, localized mainly in the back of the head or have a diffuse character. They appear with physical or emotional stress, combined with asthenia, sleep disorders, memory impairment. Then cognitive and neurological disorders come to the fore.
Spondylogenic vertebrobasilar insufficiency results from compression of vertebral arteries in injuries, degenerative diseases of the cervical vertebrae. Sharp soreness in the back of the head and neck on one side suddenly occurs after an awkward movement, spreads to the temple, eyes and forehead. It is supplemented by falls, ataxia, pronounced vegetative reactions: pallor, marbling, sweating or dry skin.
Inflammatory processes in the central nervous system
With meningitis, the pain in the back of the head is excruciating, bursting, radiating along the back of the neck. It appears against the background of intoxication syndrome. It is accompanied by an increase in muscle tone, a painful reaction to noise, light, and touch. Children may have seizures. The clinical picture of encephalitis depends on the type of disease. Typical signs are acute development with severe hyperthermia, general cerebral symptoms. Sometimes there are seizures, mental disorders, paresis, hyperkinesis.
Pain in the back of the head
Pain in the back of the head
Traumatic injuries
Pain in the back of the head or throughout the head accompanies traumatic brain injuries of any severity. The most common TBI is concussion. Along with the pain syndrome, the victims complain of weakness, nausea. At the moment of damage, loss of consciousness or a state of deafness is possible. With brain contusions, clinical manifestations are more pronounced, loss of consciousness is prolonged, meningeal symptoms are detected. Focal symptoms are possible.
A fracture of the cranial vault in the occipital bone is manifested by a sharp sudden local pain. Then the soreness spreads, supplemented by manifestations of TBI. A hematoma is found in the area of damage, sometimes an indentation is palpated. In victims with wounds to the back of the head, the pain is less intense, from acute to stinging, accompanied by profuse bleeding.
Irradiation of pain in the back of the head can be observed with subluxations of the upper cervical vertebrae. The head is in a forced position, when trying to move, the pain syndrome increases. The neck muscles are tense. Sometimes there are dizziness, convulsions, a feeling of goosebumps, weakness in the limbs.
Defeat of the cervical spine
Cervicalgia with a transition to the occipital region is found in cervical osteochondrosis. Pain is aggravated during movements, so patients keep their head still, turn their whole body. The symptom increases against the background of drafts, sleeping in an uncomfortable position. Over time, there are “lumbago” – sharp burning or throbbing pains. Possible paresthesia, muscle weakness. With an intervertebral hernia, the manifestations are aggravated.
Pulling, shooting, burning pain in the neck and nape in combination with sensitivity disorders, restriction of movements are noted in patients with spinal canal stenosis. With spondylitis against the background of infectious diseases and autoimmune pathologies, neck pain radiating to the back of the head is combined with signs of an inflammatory process.
Occipital neuralgia
It is provoked by injuries and diseases of the cervical vertebrae, hypothermia, muscle spasms, malformations, anomalies of the craniovertebral junction, some metabolic disorders, rheumatic diseases. Sometimes it develops spontaneously (Arnold’s neuralgia). It is manifested by paroxysmal pain in the back of the head (more often – unilateral) radiating into the ears, neck. Extremely acute, often painful, unbearable, resembles an electric shock or intense pulsation.
The number of paroxysms in occipital neuralgia varies from one to several dozen per day, the duration of one episode ranges from a few seconds to 1-2 minutes. Seizures develop after coughing, sneezing, sudden movements or occur for no apparent reason. Between paroxysms, symptoms are more often absent, sometimes dull aching pain, paresthesia persist.
Muscle damage
Cervical myositis develops after hypothermia or overload. First, local cervicalgia appears. Then the pain spreads to the parietal and occipital regions, the upper back. It increases with movements. Sometimes the cause of pain is myalgia. This condition is more often observed when the uncomfortable position of the head is maintained for a long time, including while working at the computer.
Heat and sunstroke
In victims of sunstroke, the headache is dull, pressing, often more pronounced in the occipital region. Combined with dizziness, drowsiness, nausea, lethargy, hyperthermia. With heat stroke, the pain in the back of the head is at first aching, bursting, non-intense. Gradually intensifies, becomes spilled. It is supplemented by nausea, increased pulse and breathing, heaviness in the chest, pallor of the skin, an increase in body temperature. Convulsions, psychomotor agitation, delirium, hallucinations are possible.
Other reasons
The symptom can be detected in the following diseases:
Anemia. Pain syndrome is provoked by oxygen starvation of the brain, soft tissues of the neck.
Heart failure. Systemic circulatory disorders lead to a lack of oxygen in the tissues.
Diabetes mellitus. The sign is observed in the first stage of hypoglycemic coma.
Erysipelas. Severe pain is typical for erysipelas of the scalp.
Diagnostics
The nature of the pathology is determined by a neurologist. According to the indications, an orthopedic traumatologist, an infectious disease specialist, and other specialists are involved in the examination. The doctor finds out the time of occurrence, duration and nature of the pain syndrome, identifies other symptoms. When collecting anamnesis, the doctor pays attention to possible provoking factors, the presence of chronic diseases.
Examination of the back of the head may indicate external changes (swelling, wounds, abrasions). Palpation is sometimes determined by tension, muscle compaction, enlarged lymph nodes. Neurological examination provides an assessment of reflexes, muscle strength, various types of sensitivity, detection of focal disorders. To clarify the diagnosis , the following are prescribed:
X-ray examination. Indications for radiography of the skull are fractures of the occipital bone, for radiography of the cervical vertebrae – subluxations, spondylitis, osteochondrosis, hernias.
Computed tomography. Allows you to detail the data obtained during radiography. The contrast technique displays vascular changes.
Magnetic resonance imaging. It visualizes brain tissues well, is assigned to study their structure, detect tumors, hematomas, areas of degeneration, and other changes.
Ultrasound methods. Ultrasound and Dopplerography make it possible to assess vascular tone, blood flow rate, and other indicators, to form a comprehensive picture of the blood supply to the brain.
Electroencephalography. It is performed to assess the functional activity of the brain, to determine the severity of violations of cerebral functions due to injuries, certain diseases
Lumbar puncture. It is performed for TBI, meningitis, encephalitis. Confirms the presence of intracranial hypertension, inflammation, bleeding.
Laboratory tests. They are informative for atherosclerosis, inflammatory and infectious processes, as well as somatic and endocrine diseases that provoke secondary arterial hypertension.
Neurologist’s examination
Neurologist’s examination
Treatment
Pre-hospital care
Emergency care is needed for sunstroke and heat stroke. The victim is transferred to a shaded place, if possible, take off his clothes, apply cold (cool, but not ice compresses) to the forehead, chest, shins, hands. To prevent dehydration, give water or weak sweet tea. Patients with suspected TBI are provided with rest, laid on their side to prevent aspiration of vomit. In case of spinal injuries, the neck is immobilized with a cotton-gauze collar or improvised means (for example, a rolled-up scarf).
Conservative therapy
The list of therapeutic measures is compiled taking into account the cause of the pain syndrome:
Migraine. Analgesics, caffeinated agents are used to relieve paroxysms. Sometimes therapeutic blockades are shown. With basilar migraine, oxygen inhalation is effective, sedatives, reflexotherapy, electroson, massage of the cervical-collar zone are recommended during the intercalative period.
Arterial hypertension. A special diet is prescribed. Correction of the underlying pathology is carried out. Medications with hypotensive effect, diuretics, disaggregants, adrenoblockers are used.
Cerebral atherosclerosis. Therapy includes a low-cholesterol diet, hypolipidemic, vascular agents, antiplatelet agents, neurometabolites.
Vertebro-basilar syndrome. Effective antihypertensive drugs, neuroprotectors, anticoagulants, antiplatelet agents, NSAIDs, antidepressants. Exercise therapy, post-isometric relaxation, hyperbaric oxygenation, magnetolaser therapy are performed.
Meningitis, encephalitis. The basis for the treatment of bacterial inflammatory processes are antibiotics and sulfonamides. In case of viral infection, general restorative and symptomatic agents are used, sometimes corticosteroids, diuretics.
Occipital neuralgia. NSAIDs, muscle relaxants, glucocorticoids, anticonvulsant medications, group B vitamins are shown. To improve the psychoemotional state, antidepressants are included in the scheme.
Myositis. The choice of pharmaceuticals is determined by etiology. With bacterial infection, antibiotics are prescribed, with parasitosis – anthelmintic agents, with autoimmune processes – glucocorticoids and immunosuppressors.
Surgical treatment
Patients with vascular pathologies undergo prosthetics of the brachiocephalic trunk, the creation of an extra-intracranial anastomosis, carotid endarterectomy. Laser vaporization of the intervertebral disc, microdiscectomy, and resection of the cervical rib are performed in patients with vertebral-basilar insufficiency caused by spinal diseases. Traumatic injuries may be an indication for PHO wounds, decompressive trepanation of the skull, removal of depressed fractures, evacuation of hematomas.
