Headache Back Of Head

by Sue
(Philadelphia, PA)

Hi,

I have been having a headache at the back of my head. It usually starts in the mornings but can happen also at work. I work in a nursing home and have to help lift people. At times it is really bad and once or twice I had to go home.

I get some nausea too. I have tried Advils and they helped a little bit.

The headaches don't happen everyday, but they do happen a couple of times a week.

Any ideas? I went to my doctor and he gave me ibuprophens but they didn't work either.

I don't have any other medical problems so I don't go to the doctor unless I have to.

Thanks.

Sue

Answer:

Hi Sue,

Headache back of head is a common complaint in many headache centers. With a history of lifting and some nausea, you may be having what is called cervicogenic headache. This is usually caused by spasms in the neck muscles. The largest muscle in the back is the trapezius which attaches at the back of the skull. When this start spasming, it creates pain in the back of the head.

But before assuming anything, you should ask your doctor to consider some testing. If you are a smoker and over 40, with a newer onset of headaches an MRI should be performed in addition to carotid dopplers. They could also consider a transcranial doppler (or TCD) which looks at the arteries in the back of the neck.

An MRI is especially important if having any other symptoms such as blurry vision, blind spots, vertigo, dizziness, weakness, or any episodes of passing out.

Assuming everything comes out fine, and it is spasming, an anti-spasmotic is the medication of choice. This can be combined with the advil or ibuprofen to use as needed. You might also consider physical therapy.

Since these headaches also occur in the morning, consider how you sleep and if you are getting the proper neck support at night. A poor or old mattress can also influence posture during sleep and cause neck and back problems.

Hope this helps..
Mary Kay Betz MS RPA-C