03 / Understand the area
Back of the head
An ache where the head meets the neck raises questions about the headache itself and about how your neck moves.
An educational guide that covers the left and right sides alike. Where it hurts is a useful clue, but only a clue.
A useful starting point
What this area can tell you.
Pain at the back of the head sometimes comes with a stiff neck, but having both doesn't prove the neck is causing the headache. Before we consider a muscle-and-joint explanation, we need to know how it started, the pattern of the headaches, and any neurological symptoms. Two details tell us a lot: if an ordinary head turn brings on the familiar pain, and if the pain spreads toward the temple or eye. Forcing a painful movement over and over to test the connection yourself won't settle it; that's part of what the exam is for.
Notice the pattern
Three questions to bring with you.
You don't need to know what it is before you come in. These are details that help when you tell us what you're feeling.
- Did the pain come on gradually, after an injury, or suddenly at full strength?
- Do normal head turns bring on the familiar pain, or does the headache come on its own?
- Does the pain spread toward an eye or temple, and do you have dizziness or changes in vision?
When to get help sooner
A sudden, unusually severe headache, new weakness or speech difficulty, or headache with fever and a stiff neck needs emergency care. A new headache after a significant head or neck injury needs prompt medical assessment.
Follow the connection
Possible explanations. Better questions.
These guides cover conditions and patterns that may overlap with this area. Think of them as a place to start our conversation: no body map can tell you which one, if any, you have.
What the studies found, and where they stop
How the research fits this area.
Everyone in the trial had been assessed as having cervicogenic headache, meaning headache that comes from the neck. What it found for exercise and manual therapy can't be stretched to cover every headache at the back of the head.
How we select and explain sources ↗Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache
200 people with cervicogenic headache, assigned to manipulation, specific exercise, both, or a control group.
What it foundManipulative therapy and exercise each reduced headache frequency and intensity, with benefits reported at 12 months.
What it can't tell usParticipants weren't blinded, and the combined approach wasn't significantly superior. The findings are about headache that starts in the neck (cervicogenic headache), not migraine in general.
Publication details & citation
Jull et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002. DOI: 10.1097/00007632-200209010-00004.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.
Your next step
Bring your questions.
We’ll start there.
Your answers to those three questions are where we start. We go over your history and symptoms, examine you, and explain what we found before we recommend anything. If it turns out to be something another doctor should look at, we'll tell you.
Anatomy: BodyParts3D, © DBCLS, CC BY 4.0. Model & rendering credits. Return to the full body explorer.