Sudden Sharp Pain in the Back of the Head

Pain in the back of the head?

Two days ago, I suddenly experienced a sharp, lightning-like pain in the area near the back of my head, specifically on the right side.
The pain occurs as a brief episode and is not consistent in timing; it can happen throughout the day.
I also feel pain when I pull my hair while brushing or when I apply pressure to the area.
I took pain relievers, but they don't seem to have much effect.
What could this issue be?

Lin, 20~29 year old female. Ask Date: 2021/02/27

Dr. Jiang Junyi reply Neurology

Hello, based on your description, cervical myofascial pain syndrome should be considered first.
Symptoms may include pain, discomfort, muscle stiffness, or a feeling of heaviness.
Symptoms may worsen with changes in weather and can be alleviated with stretching activities, often recurring.
During acute episodes, there may be localized muscle tension and spasms, leading to restricted movement.
However, some muscle disorders, such as myasthenia gravis, can also cause similar fatigue-like symptoms.
It is recommended that you consult a neurologist to discuss examination and treatment options.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2021/02/27

More Info

Sudden sharp pain in the back of the head, especially when described as a "lightning-like" sensation, can be concerning and warrants careful consideration of various potential causes. Given your description, there are several possibilities that could explain your symptoms.

1. Nerve Irritation or Compression: One of the most common causes of sharp pain in the back of the head is irritation or compression of the occipital nerves, which can occur due to muscle tension, poor posture, or cervical spine issues. This type of pain can be exacerbated by activities that involve pulling or straining the neck, such as brushing your hair. The pain may feel sharp and can radiate to other areas, including the scalp or behind the eyes.

2. Cervicogenic Headache: This type of headache originates from issues in the cervical spine (the neck). Conditions such as degenerative disc disease, herniated discs, or muscle tension can lead to referred pain in the back of the head. The pain may be sharp, and certain movements or positions can trigger it.

3. Tension-Type Headache: While typically characterized by a dull, aching sensation, tension-type headaches can sometimes present with sharp pain, especially if there is significant muscle tension in the neck and scalp. Stress, poor posture, and prolonged periods of sitting can contribute to this type of headache.

4. Migraine: Although migraines usually present with more diffuse pain and accompanying symptoms like nausea or sensitivity to light, some individuals experience sharp, localized pain. If you have a history of migraines, this could be a possibility.

5. Trigeminal Neuralgia: This condition is characterized by sudden, severe facial pain that can sometimes extend to the back of the head. It is caused by irritation of the trigeminal nerve and can be triggered by light touch or movement.

6. Other Neurological Conditions: While less common, conditions such as occipital neuralgia, which involves inflammation of the occipital nerves, or even more serious issues like a vascular headache or intracranial pressure changes could be considered, especially if the pain is persistent or worsening.

Since you mentioned that over-the-counter pain medication has not been effective, it is essential to consult a healthcare professional for a thorough evaluation. They may recommend imaging studies, such as an MRI or CT scan, to rule out any structural issues in the cervical spine or brain. Additionally, a neurologist may provide insights into whether your symptoms are related to nerve involvement or other neurological conditions.

In the meantime, consider the following self-care strategies:
- Posture Correction: Ensure that your workstation is ergonomically set up to reduce strain on your neck and back.

- Neck Stretches: Gentle stretching and strengthening exercises for the neck may help alleviate tension.

- Heat Therapy: Applying a warm compress to the neck can help relax tight muscles.

- Stress Management: Techniques such as mindfulness, yoga, or meditation can help reduce overall tension and stress, which may contribute to headache symptoms.

In summary, while sudden sharp pain in the back of the head can arise from various causes, it is crucial to seek medical advice for a proper diagnosis and treatment plan tailored to your specific situation.

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