What Causes Pain at the Back of the Head?

Occipital pain refers to a type of pain condition primarily characterized by headache, and is one of the more common clinical symptoms. Headaches are often triggered by factors such as excessive fatigue, mental stress, exposure to cold, or insufficient sleep; in most cases, symptoms subside following rest or adequate sleep. So, what causes occipital pain? Below is an explanation.

Causes of Occipital Pain

1. Trauma

If there is a clear external injury—such as localized impact or blunt force trauma—resulting in localized pain, further diagnostic evaluation is required to rule out skull fracture or soft tissue injury.

2. Cervical Spondylosis

Headache caused by cervical spondylosis typically occurs in the occipital region and neck. It results from nerve compression or irritation due to hypertrophic cervical spondylitis or osteophytes (bone spurs). Cervical X-rays may reveal signs of osteophyte formation or degenerative bone changes. Additionally, if the scalp itself is tender, this may reflect tension in the scalp nerves; gentle massage or local heat application can provide some symptomatic relief.

3. Cerebral Hypoperfusion

Occipital pain is frequently associated with cerebral hypoperfusion—a common cerebrovascular disorder among middle-aged and elderly individuals. It is often linked to underlying conditions such as hyperlipidemia, hypertension, and diabetes mellitus, which contribute to atherosclerosis. Atherosclerotic plaque formation within arteries may lead to arterial stenosis, thereby impairing cerebral blood supply and causing various neurological symptoms.

4. Muscular Contraction (Tension-Type Headache)

Also known as tension-type headache, this condition commonly arises from psychological stress, physical fatigue, prolonged writing or reading, extended computer use, or poor posture. These factors induce sustained contraction of head, facial, or cervical muscles, along with cerebral vasoconstriction, resulting in headache. Occipital pain specifically may reflect spasm of the posterior cervical musculature. Furthermore, exposure to cold during sleep may cause stagnation of qi and blood in the nape and upper back, contributing to this symptom.

The above outlines the primary causes of occipital pain. We hope this information proves helpful to you.