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There are many reasons why a headache can occur in the top part of the head. Tension, migraine, and occipital neuralgia are some of the possible causes. In some cases, a person may need medical attention.
In some cases, a person may need to consult a doctor about a headache, especially if it is severe, persistent, or occurs with other symptoms.
Here, learn about some causes of headaches that can affect the top of the head, why they happen, and when to seek medical help.
Tension-type headaches are some of the most common headaches. Experts sometimes call them muscle contraction tension headaches. While muscular tension may play a role, it is not clear exactly why they happen. Other possible causes include vitamin deficiencies and genetic factors. One study has suggested that at least 78% of people experience a tension-type headache at some time.
In a tension-type headache, the pain feels as if it is squeezing or adding weight to an area, such as the top of the head. People will also feel pain in their neck or shoulders in some cases.
People often describe the pain from tension headaches as dull and say it does not throb or pulsate. Tension headaches are usually uncomfortable but not severe. They can last from 30 minutes to a week, but the average duration is 4–6 hours.
Headache is one of the symptoms of migraine. Migraine headaches affect up to 12% of the population, including 17% of females and 6% of males. They are less common than tension headaches but can be more severe.
The pain may feel as if it radiates from the top of the head, along one side, or down the back of the neck. It can be severe and throbbing and occur along with other symptoms, including nausea and extreme sensitivity to light or sound.
Genetic factors appear to play a role, but many people with the condition find that specific triggers can cause migraine headaches. These include stress, weather changes, sleep problems, and hormonal changes.
There are different types of chronic, or persistent, headache. They include tension-type headaches and migraine headaches.
A doctor will diagnose a chronic tension-type headache if a person has a tension-type headache on at least 15 days a month for 3 months or longer. Chronic migraine headaches also occur on at least 15 days a month for 3 months or longer, and the person will have migraine symptoms on at least 8 days a month.
The symptoms will depend on the type of headache, but some can cause pain near the top of the head. Lifestyle factors, such as stress and lack of sleep, can influence chronic tension headaches.
As the name suggests, cluster headaches occur in groups. They appear suddenly on one side of the head, often behind the eye, and they cause severe pain as well as nasal congestion or a runny nose, and a watery eye. They are rare, affecting around 1 in 1,000 people.
Cluster headaches may involve changes in the trigeminal nerve, the hypothalamus, and blood vessel dilation. However, experts do not know exactly why they happen. They can occur in response to triggers such as watching television, drinking alcohol, hot weather, and stress.
Cluster headaches tend to occur in groups. An attack can last from several weeks to a few months, but may then stop for several years. During an attack, they can occur from every second day up to eight times a day. A person may find it hard to get rest or relief during this time.
Sickness or infection can inflame the sinuses, resulting in pain in the sides and top of the head. The symptoms usually disappear when a person treats the underlying issue. A doctor may recommend medications to help with inflammation. People with long-term sinus problems may need surgery.
Sleep disruption can lead to headaches, but headaches can also worsen sleep problems. Tension-type headaches may occur when a lack of sleep causes the body to release less of a chemical known as orexin. Orexin plays a role in nervous system function, sleep, and arousal.
Hypnic headaches can cause a person to wake up from sleep, usually at the same time each night. They usually last at least 15 minutes and tend to affect people aged over 50 years. Doctors do not know why they happen, but there may be links with pain management, REM sleep, or melatonin production.
Occipital neuralgia involves irritation to the nerves leading from the spine to the top of the head. This can cause pain in the back or top of the head.
A person may feel as if they have a tight band on their head. They may also experience tingling or jolts of shocking pain. The scalp may feel tender and a person’s eyes can be sensitive to light.
- trauma to the back of the head
- pinching of the nerves due to tight neck muscles
- nerve compression resulting from osteoarthritis
- a tumor in the neck
A doctor will carry out tests to look for an underlying cause, although sometimes there is no clear cause.
Frequent use of over-the-counter (OTC) or prescription pain relief can result in overuse or rebound headaches. People with persistent migraine are especially prone to overuse headaches.
A doctor will consider the possibility of an overuse headache if the person has a diagnosis of a primary headache condition and experiences headaches on at least 15 days a month.
Exposure to cold temperatures may cause a cold-stimulus headache, or “brain freeze,” with pain at the front of the head toward the top. It can happen when eating a large bite of something frozen or consuming very cold drinks.
The scientific term for brain freeze is sphenopalatine ganglioneuralgia, as it affects the sphenopalatine ganglion. This ganglion is linked to nerves in the sinuses.
When a person eats something cold, a sharp, severe pain hits the top of their head and lasts only a few seconds. It disappears once the cold temperature in the head has dissipated. However, experts have also linked the sphenopalatine ganglioneuralgia to other types of headaches, including cluster and migraine headaches.
Some people develop a throbbing headache when they do sudden, intense exercise, such as running sprints or having sex. Doctors call this a primary exercise or exertional headache. It may be due to a rise in blood pressure, according to the American Migraine Foundation.
However, there is also evidence that exercise can help reduce migraine headaches.
Eating some protein source, such as nuts, around 1.5 hours before exercising, staying hydrated, and warming up may all help reduce the risk.
Anyone who experiences a severe headache after exercising or has concerns about the impact of exercise on headaches should seek medical advice.
High blood pressure rarely causes a headache, but the American Heart Association notes that it may do so if blood pressure is 180/120 mm/Hg or above.
In rare cases, a head injury, stroke, or brain abscess can cause a condition known as intracranial hypertension, where pressure builds up around the brain. This can cause a throbbing headache, vision changes, nausea, and other symptoms.
A severe, sudden, “thunderclap” headache may be a sign of reversible cerebral vasoconstriction syndrome (RCVS) due to a life-threatening condition such as bleeding in the brain or a stroke. This type of headache needs immediate medical attention.
There are not many muscles on the top of the head, but they may play a role in some types of headaches. A tightening of the neck and head muscles may play a role in tension-type headaches. Around the head, excessive muscle contraction may reduce blood supply and lead to the release of substance P, which can worsen pain.
There are several ways of treating a headache in the top of the head, depending on the cause.
- OTC pain relief, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- dietary measures, such as consuming more water and reducing alcohol intake
- massage, including self-massaging the head and neck
- relaxation techniques
- reducing stress levels with breathing exercises or yoga
- getting the right amount of sleep
- seeing a physical or massage therapist
- cool packs for the head
If a doctor identifies a specific reason for a headache, they may offer treatment to address the cause.
Shop here for a range of over-the-counter treatments for headache pain.
A person should seek medical help if they have:
- a severe, sudden headache
- persistent headaches that do not respond to home treatment
- other symptoms, such as nausea and vision changes
A doctor may prescribe medications or carry out tests to see if there is an underlying cause that needs specific treatment.
There are many reasons why a headache may affect the top part of the head. Tension-type headaches are the most common cause and often respond to home treatment. However, a sudden, severe, or persistent headache may be due to an underlying cause that needs medical treatment.
Anyone experiencing troublesome or persistent symptoms should seek medical help. If a person has a sudden, severe, thunderclap headache, someone should call 911 or take the person to the nearest emergency room.
Last medically reviewed on June 17, 2021
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- Al Khalili, Y., et al. (2021). Hypnic headache.
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- Shah, N., et al. (2021). Muscle contraction tension headache.
- Togha, M., et al. (2021). Reversible cerebral vasoconstriction syndrome (RCVS): An interesting case report.
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Headache on the Top of the Head
Pain at the top of the head can be caused by a variety of different types of headaches including tension headache and migraine.
Headaches are never fun, and each type of headache can produce its own unique symptoms. Headaches that occur on the top of the head may cause the sensation of having a heavy weight placed on the crown of your head or a tight band across the head.
Identifying exactly what type of headache you’re experiencing is crucial to finding the right treatment and getting relief.
Several different conditions can cause headaches on top of your head. These can include different types of headaches, nerve issues, and more rare causes.
There are a number of different forms of headache that can cause pain on top of the head.
Tension headaches cause constant pressure or aching around the head, which may feel like a tight band has been placed around the head.
You may also feel pain in your neck and near the back of your head or temples. The pain is dull and doesn’t throb, and it’s often much less severe than that of a migraine. Although these headaches are uncomfortable, many people with tension headaches are able to resume their typical activities.
Episodes of tension-type headaches can last from about 30 minutes to 1 week .
Migraine is a neurological condition that causes severe and debilitating headaches. It may cause headache pain on the top of the head, though it may also appear on or travel to one side of the head or the back of the neck.
Migraine can cause severe throbbing pain , along with symptoms that can also include:
- light sensitivity
- sound sensitivity
- auras, or visual disturbances
Migraine can be episodic or chronic, depending on how often the headache attacks occur.
Cold-stimulus headaches — commonly known as “brain freezes” — come on quickly and are felt near the top of the head. They will be severe, and typically only last a few seconds. They may occur after you eat or drink something cold, such as ice water or ice cream.
Chronic headaches occur when a person experiences headaches for 15 or more days of the month. This is an umbrella term that doctors use to refer to multiple conditions.
Chronic headaches can come in many different forms. These can include:
- migraine, which can be chronic or episodic (occurring less frequently)
- tension headache
- cluster headaches, which are severe headaches that occur in clusters followed by headache-free periods
- new daily persistent headache, a rare headache condition that is not caused by another disorder
- hemicrania continua, a severe headache that occurs on one side of the head
Occipital neuralgia occurs when the nerves that move from the spine to the scalp are damaged, irritated, or compressed. They can cause pain at the back of the head, or a tight, band-like feeling around the top of the head.
Other symptoms can include:
- jolts of pain that feel like electric shocks
- dull aching
- symptoms that increase upon movement