From the Guidelines
Yes, tension headaches can occur in the back of the head near the neck, and physical therapy is suggested for their management. These headaches typically feel like a tight band of pressure around the head and can extend from the back of the head (occipital region) down to the neck. They're often caused by muscle tension in the neck and scalp, which can result from stress, poor posture, or prolonged desk work 1.
Key Points to Consider
- Tension headaches in the back of the head near the neck are a common presentation of tension-type headache.
- The suggested management includes noninvasive approaches such as physical therapy, as indicated by the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache 1.
- Additional strategies for relief may include applying a warm compress to the neck, gentle stretching, massage, stress management techniques, and taking regular breaks from activities that strain your neck muscles.
- Improving your posture and ergonomics at work can help prevent recurrence.
- If headaches are severe, persistent, or accompanied by other concerning symptoms like fever or vision changes, you should consult a healthcare provider for proper evaluation.
Management Options
- Physical therapy is a suggested approach for managing tension-type headaches, including those occurring in the back of the head near the neck 1.
- Aerobic exercise or progressive strength training may also be beneficial for preventing tension-type headaches 1.
From the Research
Tension Headache Location
- Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput, which is the back of the head by the neck 2.
- The pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache 2.
- Patients typically describe headache pain as pressing, dull, and with the sensation of a tight band around the head, which can include the back of the head by the neck 3.
Characteristics of Tension Headache
- Tension-type headache is characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity 4.
- The headache pain is usually bilateral, meaning it occurs on both sides of the head, and can radiate to the back of the head and neck 4.
- The pain is often described as a band or a squeezing sensation around the head, which can include the back of the head by the neck 3.
Diagnosis and Treatment
- Diagnosis is based on headache history and the exclusion of alternative diagnoses, with clinical criteria provided by the International Classification of Headache Disorders, third edition 4.
- Treatment of tension-type headache typically involves the use of over-the-counter analgesics, such as paracetamol or ibuprofen, which can be effective in relieving headache pain, including pain in the back of the head by the neck 5, 6.