Differential Diagnosis for Dull Ache at Back of Head and Jaw Side of Head

Single Most Likely Diagnosis

• Tension Headache: This is the most common type of headache and is often described as a dull ache or pressure around the head, including the back and sides. It can be triggered by stress, poor posture, or muscle tension, which could easily involve the jaw and the back of the head.

Other Likely Diagnoses

• Temporomandibular Joint (TMJ) Disorder: Given the involvement of the jaw, TMJ disorder is a plausible diagnosis. It can cause pain in the jaw, face, and temples, and can also refer pain to the back of the head.
• Migraine: Although migraines are typically unilateral and throbbing, some individuals may experience a dull ache, especially in the early stages or as part of a migraine aura. The pain can be on one side of the head, including the jaw area.
• Cervicogenic Headache: This type of headache originates from the cervical spine and can cause pain on one side of the head, including the back and jaw area, due to referred pain from the cervical nerves.

Do Not Miss Diagnoses

• Giant Cell Arteritis: Although less common, giant cell arteritis is a critical diagnosis not to miss due to its potential for causing blindness if not treated promptly. It typically presents with headache, jaw claudication, and visual symptoms in older adults.
• Temporal Arteritis: Similar to giant cell arteritis, temporal arteritis can cause severe headaches, often on one side, and jaw pain. It's essential to consider this diagnosis to prevent potential complications like vision loss.
• Subarachnoid Hemorrhage: A severe headache that comes on suddenly, often described as "the worst headache" of one's life, could be indicative of a subarachnoid hemorrhage. Although the pain typically starts at the back of the head, it can spread and involve other areas.

Rare Diagnoses

• Occipital Neuralgia: This condition involves the nerves that run from the back of the head to the scalp and can cause sharp, stabbing pain or a dull ache, typically on one side of the head.
• Trigeminal Neuralgia: Although more commonly associated with facial pain, trigeminal neuralgia can cause severe, stabbing pain that might be perceived as a dull ache between episodes, potentially involving the jaw area.
• Eagle Syndrome: This rare condition involves an elongated styloid process or calcified stylohyoid ligament, which can cause sharp or dull pain in the jaw, face, and side of the head, including the area behind the ear.