Causes of a throbbing headache at the back of the head

People can experience a range of headaches that can cause different types of pain, including a throbbing ache at the back of the head. This pain can result from a headache or other medical conditions.

According to the National Institute of Neurological Disorders and Stroke, headaches are among the most common forms of pain.

Sometimes, headaches can be a symptom of an underlying health condition. One of the things doctors look for when trying to understand the cause of a headache is the type and location of the pain.

This article will explain what can cause a throbbing headache at the back of the head, also called occipital headaches. You will also learn about treatment methods, and when to speak to a doctor.

Occipital neuralgia

Causes of a throbbing headache at the back of the head
Sexual activity, migraines, and various other medical conditions can induce headaches with pain centralized at the back of the head.

Damage or pressure on the nerves of the upper part of the spinal column, neck, scalp, and back of the head can result in occipital neuralgia, or headaches that start in the neck.

According to the National Institute of Neurological Disorders and Stroke, this type of headache feels like a piercing or throbbing pain in the upper neck, behind the ears, and at the back of the head.

The pain usually starts in the back of the neck then spreads. Some people will also experience pain on the scalp, forehead, or behind the eyes. They might also be sensitive to light or sound.

Treatment of occipital neuralgia

This condition will usually get better on its own. To manage the symptoms, a person can try:

  • getting plenty of rest
  • using a heating pad on the head
  • taking over-the-counter anti-inflammatory medications, such as ibuprofen

Sometimes, doctors might recommend muscle relaxants. If the pain is severe, doctors might prescribe antidepressants or steroid injections.

Migraine headaches

Most migraines cause severe, throbbing headaches on one side of the face and head.

However, according to a 2020 study, people with vestibular migraine headaches are more likely to experience ache in the back of the head.

Migraine headaches are a neurological condition, and some people have a genetic predisposition to them. In other people, migraine headaches develop as a result of certain factors or situations.

These factors include stress, hormonal changes, flashing lights, too much or too little sleep, and sudden changes in weather.

Before the migraine headache starts, that person might experience warning signs, such as food cravings, mood changes, uncontrollable yawning, fluid retention, or increased urination.

Some people will then see flashing or bright lights, which doctors call an “aura,” before the migraine headache starts.

Symptoms of migraines include:

  • a headache that gets worse when the person moves
  • nausea or vomiting
  • being weak
  • sensitivity to light
  • sensitivity to sound

Treatment of migraine headaches

There are many effective preventive and treatment medications for migraine headaches.

Doctors also advise people to try to avoid factors which cause the headache.

Other ways to ease the symptoms include:

  • resting in a quiet, darkened room with eyes closed
  • placing an ice pack or cool cloth on the forehead
  • drinking plenty of water

Head trauma

A headache due to head trauma can result from a concussion, a skull fracture, or bruising of the brain.

Pain can affect any location on the head, including the back of the head.

A person should seek help if they notice the following symptoms:

  • a persistent headache
  • repeated vomiting and nausea
  • convulsions
  • enlarged pupils
  • slurred speech
  • weakness in the arms or legs
  • lack of coordination
  • confusion
  • restlessness and agitation

A doctor will order brain imaging scans to rule out a major issue that could require surgery.

Treatment of head trauma

Treatment can include pain medication, rest, and rehabilitation.

Intracranial hemorrhage

An intracranial hemorrhage is bleeding inside the brain or the skull.

These headaches are very serious, and they can occur due to a stroke or a bleeding aneurysm in the brain.

These problems cause severe pain, often all over the head or in the back of the head.

The bleeding may also produce neurological symptoms, such as weakness or seizures.

Treatment of intracranial hemorrhage

An intracranial hemorrhage is a medical emergency, which requires intensive care and might need surgical treatment.

Intracranial hypotension

Intracranial hypotension is quite rare. Intracranial hypotension happens when the spinal fluid leaks out of a hole in the spinal cord, causing problems with pressure inside the brain.

According to the National Organization for Rare Diseases, 5 out of every 100,000 people experience spontaneous intracranial hypotension. Usually, this problem occurs due to a brain tumor, trauma, or a side effect of a medical procedure.

The symptoms might come on gradually or suddenly.

The most common symptom is a headache that gets worse when the person is upright. The headache can be a throbbing pain in the back of the head.

Other symptoms include:

  • nausea and vomiting
  • pain or stiffness in the neck pain
  • pain between shoulder blades or in the arms
  • dizziness and balance problems
  • sensitivity to light or sound
  • muffled hearing or hearing a ringing sound
  • cognitive impairment, or changes in the ability to think clearly

Treatment of intracranial hypotension

National Organization for Rare Diseases indicates that in some cases, symptoms may resolve without treatment. However, they advise that a person rests and drinks a plenty of water.

Doctors will perform a surgical procedure to mend the spinal cord and stop the fluid leaking.

Brain tumor

A throbbing headache at the back of the head might be a sign of a brain tumor.

The pain happens when the tumor presses against the brain’s blood vessels and nerves or causes swelling and fluid buildup.

According to the American Brain Tumor Association, people who have a brain tumor sometimes have pain that:

  • is worse in the morning
  • is accompanied by vomiting
  • gets worse when coughing, exercising, or moving
  • does not get better when that person takes over-the-counter pain medication, such as aspirin or ibuprofen

Other symptoms of a brain tumor include:

  • seizures, including muscle spasms or twitches, a loss of consciousness, loss of control of bodily functions, or changes in vision, sensation, or smell
  • personality changes
  • feeling extremely tired
  • sleeping problems
  • memory problems
  • problems carrying out everyday activities

Treatment of a brain tumor

Treatment is different for everybody. Treatment is usually a combination of surgery, chemotherapy, and radiotherapy.

Headache associated with sexual activity

According to the American Migraine Foundation, a primary headache can occur during sexual activity (pre-orgasmic) or during orgasm.

An orgasmic or pre-orgasmic headache is usually a sudden headache that turns into a severe throbbing sensation, but it can be a dull pain as well.

The pain can occur on both sides of the head or at the back of the head.

If a person experiences a headache with sexual activity, they should see a doctor who can rule out any other potential causes, such as cardiovascular disease, a brain aneurysm, or a brain tumor.

Treatment of headache associated with sexual activity

These headaches typically last between 1 minute to 24 hours.

However, if these headaches recur frequently or last for longer, a person can take triptans and propranolol to help ease the pain.

Tension headache

A tension headache can occur anywhere on the head, including the back of the head.

According to Johns Hopkins Medicine, tension headaches are very common. Tension headaches usually cause a dull ache, rather than throbbing pain. The pain feels like a tight band around the head.

Tension headaches can occur due to fatigue, stress, hunger, or without an obvious cause.

Treatment of tension headache

A person can take over-the-counter medications to relieve the pain from a tension headache.

When do you need to see a doctor?

People should seek medical help if they:

  • have a new headache
  • have regular headaches
  • have a headache alongside other symptoms, such as a fever, confusion, stiff neck, vision loss, numbness, and vomiting
  • have a headache that never goes away

According to the National Headache Foundation, people should also see a doctor if over-the-counter painkillers cannot relieve the headache, or they need to take painkillers more than 2 days a week.

A person should seek emergency medical attention if:

  • they experience the worst headache they have ever had
  • they are having the worst migraine attack they have ever experienced
  • they have a headache alongside vision loss, excessive vomiting, loss of consciousness
  • they experience a headache for 72 hours with a pain-free period that lasts less than 4 hours


Lots of different things can cause headaches. Headaches can interfere with a person’s quality of life, but most of them are nothing to worry about.

Sometimes, a throbbing headache in the back of the head might be a sign of an underlying health condition, such as migraine, intracranial hemorrhage, or occipital neuralgia.

Anyone who thinks that an underlying health condition is causing their headaches should speak to a doctor.

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