What does a headache at the back of the head mean?

A headache that starts or lingers at the back of your head can feel like a dull ache, a stabbing pain, or tight pressure at the base of your skull. This type of discomfort can make it difficult to concentrate, sleep or move your neck freely. It can even radiate to your shoulders or forehead, depending on the underlying cause.

Unlike migraines or sinus headaches, pain at the back of your head often originates from muscle tension, poor posture, or cervical spine issues. While over-the-counter medication may offer short-term relief, physical therapy can help address the root cause and reduce how often these headaches occur.

5 Common Causes for a Base of Skull Headache

Pain in this area is typically mechanical in nature, meaning it’s often linked to muscle, joint, or nerve dysfunction. Some of the most common causes include:

Tension headaches

Tension-type headaches are the most common type of headache and frequently cause pain in the back of the head and neck. They are often triggered by stress, muscle tightness, or fatigue. You may feel like there’s a band squeezing your head, especially after a long day of working at a desk or looking down at a phone.

Poor posture

Slouching, forward head posture, and long hours in a static position (like sitting at a computer) can place stress on the muscles at the base of your skull. Over time, this strain can lead to discomfort and contribute to chronic headaches.

Cervicogenic Headaches

These headaches start in the neck and refer pain to the back of the head. Cervicogenic headaches are typically caused by joint dysfunction or muscle imbalances in the upper cervical spine. The pain may be one-sided and worsen with certain neck movements or pressure.

Occipital Neuralgia

Occipital neuralgia is a less common but very painful condition involving irritation or inflammation of the occipital nerves. These nerves run from the spinal cord up to the scalp. Pain is often described as sharp, shooting, or electric-like and may worsen when turning your head or touching your scalp.

TMJ Dysfunction

Jaw problems, including temporomandibular joint (TMJ) disorders, can refer pain to the base of the skull and neck. TMJ issues can also contribute to muscular tension that aggravates headaches.

Physical Therapy Can Help Determine & Relieve Your Back of Head Headache Causes

If you’re tired of recurring headaches that stem from your neck or posture, physical therapy can offer targeted relief. A licensed PT will first perform a comprehensive evaluation to identify the source of your pain, whether it’s muscle tension, joint restriction, nerve irritation, or postural dysfunction.

Depending on your specific needs, treatment may include:

Manual Therapy

• Hands-on techniques such as soft tissue mobilization, trigger point release, and joint mobilization can reduce muscle tension and improve mobility in the neck and upper spine.

Postural Retraining

• Your therapist can help you correct poor posture habits that contribute to chronic headaches. They’ll teach you ergonomic strategies for sitting, working, and moving throughout your day with better alignment.

Neck & Upper-Back Strengthening

• Weak muscles in the upper back and deep neck flexors can allow poor mechanics to persist. Strengthening these areas helps stabilize the spine and support better head positioning.

Stretching & Mobility Exercises

• Gentle stretches for the neck, shoulders and upper back can improve flexibility, reduce stiffness and relieve pressure on irritated nerves or tight muscles.

Education & Home Management

• You’ll also learn how to modify daily activities to avoid future flare-ups — including sleep positioning, screen time breaks, and relaxation techniques to manage stress-related muscle tension.

Stop Letting Cervicogenic Headaches, or Any Other Headache at the Back of the Head, Interrupt Your Life

At Lattimore Physical Therapy, we understand how disruptive persistent headaches can be. Whether they stem from posture, stress, or neck dysfunction, our experienced therapists can help you find lasting relief. We’ll work with you one-on-one to build a personalized treatment plan focused on restoring comfort and reducing the chances of recurrence.

Contact our team today for more information or to schedule an appointment.