Headaches can occur in various locations, each with its own potential causes and implications. Unilateral headaches, meaning they occur on one side of the head, are often associated with migraines. Headaches behind the eyes can also indicate migraines, while those at the back of the head may suggest tension or cervicogenic headaches. Headaches consistently occurring in one location, combined with red flag signs like worsening with coughing, straining, bending over, or new vision changes, can sometimes imply a secondary headache source, raising concerns about a tumor or increased pressure within the head. In such cases, evaluation by a neurologist and possibly an MRI of the brain may be warranted to assess the brain's structure. It's important to note that the location of your headache alone is not sufficient for a definitive diagnosis, but it can serve as a good starting point for identifying the underlying cause.
Considering the Type of Pain
In addition to the location, understanding the type of pain can provide further insight into the nature of your headache:
- Tension headache: This type of headache is characterized by a dull, "tightening" feeling that doesn't throb. It is commonly triggered by factors such as stress, lack of sleep, allergies, eyestrain, caffeine withdrawal, hormonal changes, injury or trauma, vigorous exercise, hangover, hunger or dehydration, brain freeze, rebound effect from stopping anti-headache medication, high altitude, or temporomandibular joint (TMJ) problems associated with clicking or popping in the jaw.
- Migraine: Migraines typically involve throbbing pain that lasts for a while and is accompanied by symptoms like nausea, changes in vision, and sensitivity to light and noise. While migraines can be one-sided, they may affect both sides in some individuals. Migraines can sometimes be mistaken for sinus infections due to accompanying runny nose, stuffiness, and watery eyes. Recognizing the triggers that lead to migraines is key to managing and preventing them. Rarely, certain conditions such as autoimmune diseases (e.g., arthritis, giant cell arteritis), hemicrania continua, or brain tumors can cause migraine-like symptoms.
- Cluster headache: Cluster headaches are characterized by intense, searing, one-sided pain that occurs repeatedly for several days at around the same time. They are often accompanied by nasal congestion, tearing, sweating, and restlessness. Cluster headaches tend to run in families.
- Sinus headache: Sinus headaches are associated with cold-like symptoms, pressure, or tenderness in the face. However, true sinus headaches are less common than often believed and can be mistaken for other types.
- Occipital neuralgia: This chronic disorder involves brief, sharp, "electric shock" jolts that last only a few minutes or seconds. It is caused by pinched or damaged nerves running from the spinal cord to the scalp.
Recognizing More Serious Conditions
While rare, serious conditions like strokes, aneurysms, or hemorrhages can cause intensely painful "thunderclap" headaches. However, unless the pain is sudden and severe, common headaches are much more likely. If you suspect a serious condition, it is important to seek immediate medical attention, such as calling 911.
For tension headaches and mild migraines, over-the-counter (OTC) pain relievers containing ingredients like acetaminophen, aspirin, or ibuprofen can provide relief. However, recurrent or severe migraines and cluster headaches may require stronger prescription medications and preventive treatments. It's important to avoid excessive use of OTC pain relievers, as they can lead to overuse headaches.
Sinus headaches may be temporarily alleviated by pain relievers, decongestants, and antihistamines, but addressing the underlying infection is necessary.
If your headache is associated with nerve pain or autoimmune diseases, it is essential to involve your doctor for proper diagnosis and treatment.
In conclusion, understanding the location and type of pain can help narrow down the potential causes of your headache and guide appropriate treatment. Consulting with your doctor is crucial to identify the underlying cause and determine the most suitable course of action.
Headache Location |
Most Common Cause |
Other Possible Causes |
Layman's Explanation |
Back of your head or neck |
Tension headache, Migraine |
Arthritis in your upper spine, Occipital neuralgia |
Headaches at the back of your head or neck, can be caused by muscle tension or nerve issues |
Top of your head ("Hair band" area) |
Tension headache, Migraine |
Occipital neuralgia, Severe hypertension (rare), Aneurysm or bleeding (rare) |
Headaches at the top of your head, like a band squeezing your head, can be caused by muscle tension or other underlying conditions |
Forehead, Cheeks, Behind both eyes |
Tension headache, Migraine, Cluster headache |
Sinus infection |
Headaches in these areas, sometimes accompanied by sinus symptoms, can be related to sinus inflammation or various headache types |
Behind one eye |
Cluster headache |
Migraine, Occipital neuralgia, Eye infection, Aneurysm (rare) |
Sharp, severe headaches occurring behind one eye, often accompanied by eye redness or tearing, can be cluster headaches or other underlying causes |
Temples |
Tension headache |
Migraine, Cluster headache, Temporal arteritis (more common in the elderly), Temporomandibular joint (TMJ) disorder |
Headaches in the temples, often described as a pressing or throbbing sensation, can be due to muscle tension or other conditions affecting the temples |
Behind the ear |
Ear infection (more common in children) |
Occipital neuralgia, Sinus infection, Temporomandibular joint (TMJ) disorder, Dental problems, Mastoiditis |
Headaches behind the ear, sometimes associated with ear symptoms, can be related to ear infections or other underlying issues |
On one side of your head |
Migraine, Cluster headache |
Hemicrania continua (rare), Aneurysm (rare) |
Headaches that occur only on one side of the head, often pulsating or throbbing in nature, can be migraine or cluster headaches, or less commonly, other causes |
Hurts all over |
Tension headache |
Migraine, Sinus infection |
Generalized headaches that affect the whole head, often described as pressure or tightness, can be tension headaches or related to sinus inflammation |
Please note that this simplified chart provides a general understanding of headache locations and possible causes. It's important to consult with a healthcare professional for a proper evaluation and diagnosis if you are experiencing persistent or concerning headaches.