The Location of Headache Matters - it's a clue to Diagnosis.

While there is some overlap, some headaches are more likely in one area than another.

1. Pain in the back of the head
• The most common cause of a headache in the back of head is pain stemming from the joints at the top of the neck. This is called cervicogenic headache, but there are several other causes.
2. Pain in the Temple, or one side of the head only
• Migraine is the leading cause of this. However there is a long list and some have specific treatments with a good chance of success.

  Cervicogenic Headache can also cause pain that spreads round the side of the head instead of staying at the back.

  Nummular Headache is a recently described, non-serious, cause of pain in the side of the head, sometimes associated with a small area of hair loss over the painful spot.

  Temporal Arteritis classically causes pain in the temple, and often a feeling of tenderness of the scalp when combing your hair. Temporal arteritis requires prompt medical attention, and affects people over the age of 50 years.

  PS - The technical, medical term for a one-sided headache is Unilateral Headache




3. Headaches in both Temples or Both Sides of the Head at once
• If the location of headache is in both temples, as opposed to just one temple, there is a slightly different list of causes.

  If a pressure type pain is probably tension-type headache, especially if both sides.

  Ice-pick headaches will often cause repeated sharp pains in the temples, as can pain from cervicogenic headache.

  Headaches due to changes in your environment or body's metabolism can cause this type of headache.

4. Pain Behind The Ear
• It is important that ear disease and disease of the bones around the ear are ruled out.

  I've listed about 16 different headache conditions in the link above.




5. Headache on Top of Head
• This is not that common location of headache in my own practice, but the link will tell you about 34 different causes!

  Provoked headaches from exercise also cause pain on top of the head and will need investigated.

6. Pain in Eye
Just like the ear, eye disease, especially iritis or glaucoma should be excluded before going down the line of looking for a headache condition.

Ice-pick pains were once called "ophthalmodynia fugax" meaning a brief sharp pain in the eye, and this is the most common location of an ice-pick pain.

7. Face Pain
• Migraine will involve the face in about 40% of cases at some time, and this would be the leading neurological cause.

  Trigeminal neuralgia is an extremely intense shooting pain in the face, usually the jaw or cheek - it usually responds very well to Carbamazepine tablets.

  Some people with cluster headache report a lot of pain into the face, as well as being focussed around the eye.

  Chronic unexplained facial pain is fairly common and difficult to treat. Other causes of increasing facial pain include acute maxillary sinus infection - the pain of this usually follows a recent cold, and there is a discharge from the nose.

  Stooping forward often makes maxillary sinus pain worse (which is true for most sinus infections) and the teeth of the upper part of the mouth are tender and sore too.