A headache on top of the head may be worrying but, in many cases, it is not a cause for concern. However, there are several different types of headache, and each may have its own trigger in different people.

People have muscles and nerves that can contribute to a headache, and they may need to visit the doctor with certain symptoms.

It is important to understand the different types of headache to be able to identify what might be the underlying cause of a headache on top of the head.

Common causes

The following types of headache may cause pain on the top of the head:

1. Tension headache

Man with headache on top of head holding forehead in pain.
A tension headache may cause pain on the top of the head.

Most people experience tension headaches at times.

They describe them as a pain that 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.

The pain from tension headaches is often described as dull and does not throb or pulsate. Tension headaches are usually uncomfortable but not severe.

2. Chronic headaches

Chronic headaches may be persistent sources of pain. Symptoms may mimic tension headaches, and they often cause pain near the top of the head. Lifestyle factors, such as stress and lack of sleep, can influence chronic tension headaches.

3. Migraine headache

Migraines are less common than tension headaches but can be more severe. Many people say the pain feels as if it radiates from the top of the head, along one side, or down the back of the neck.

The pain is often described as severe and throbbing, and it may be felt along with other symptoms, including nausea and extreme sensitivity to light or sound.

4. Brain freeze

Exposure to cold temperatures may cause a cold-stimulus headache or brain freeze. This can happen when eating a large piece of ice cream or consuming very cold drinks.

This type of headache is a sharp, severe pain that hits the top of the head and lasts only a few seconds. It disappears once the cold temperature in the head has gone.

5. Cluster 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. Nasal congestion or a runny nose, and a watery eye may accompany the pain.

People with cluster headaches may not be able to rest or find relief when they are having an attack.

6. Sinus headaches

Sinuses can become inflamed through sickness or infection, which could cause a pain in the sides and top of the head. The symptoms usually disappear once the underlying issue or infection has been treated, and doctors may recommend specific medications to help with inflammation.

7. Sleep headaches

Poor sleeping posture can bring on sleep headaches, also called hypnic headaches. Issues in the spine may become more pronounced during sleep, which could cause a headache on the top of the head after waking. Adjustments in posture may help with symptoms.

8. Occipital neuralgia

Young woman with headache speaking to doctor.
Headaches that are severe or long-lasting should be investigated by a doctor, as they may be caused by an underlying condition.

Occipital neuralgia is pain that occurs when nerves that lead from the spine to the top of the head are irritated.

This can cause pain in the back or top of the head and may also make people feel as if they have a tight band on their head.

People with occipital neuralgia may also experience tingling or jolts of shocking pain. Doctors will look to treat any underlying issue causing this nerve damage.

9. Overuse headaches

Taking too much medication can cause an overuse or a rebound headache. Many over-the-counter (OTC) medications used to treat headaches can lead to overuse headaches.

People with frequent headaches should avoid adding to the discomfort by not using OTC medications too much.

10. Sleep deprivation headaches

Lack of sleep or physical exhaustion can trigger a headache, even when someone is not prone to headaches.

The pain is often described as a heaviness or dull ache combined with sluggishness. If a person gets more sleep, it may reduce symptoms.

11. Exercise headaches

In some people, a headache may be triggered by sudden intense exercise, such as running sprints or having sex.

In some circumstances, such as when embarking on physical exercise, a person may be able to avoid symptoms by warming up first.

Rare causes

A person may experience certain rare causes of a headache on top of the head that are medical emergencies and require immediate attention:

Hypertension headaches

Extremely high blood pressure may cause a headache on the top of the head. The resulting headache feels as if the hair and scalp are being pulled into a tight ponytail.

The pain is excruciating, and it can lead people to go to the emergency room.

Reversible cerebral vasoconstriction syndrome (RCVS)

RCVS often triggers a thunderclap headache. This is a severe, sudden headache that can be associated with life-threatening conditions, including bleeding in the brain or a stroke.

When a person has a severe headache that comes on suddenly, it requires immediate medical care.

Do the muscles in the head play a role?

There are not many muscles on the top of the head, but they may play a role in certain types of headaches.

Factors such as eyestrain, poor posture, or grinding the teeth weaken the muscles on the top of the head. An injury may also cause stress in the area.

Similarly, the muscles in the neck may be tight, which could cause neck pain or contribute to a headache.


There are a number of ways a headache on top of the head can be treated:

OTC medications

Aspirin in bottle top down view.
Aspirin is a popular treatment for headaches.

An occasional headache may be treated with OTC medications. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), which are available online, such as ibuprofen (Advil), aspirin (Bayer), and naproxen (Aleve), as well as pain relievers, including acetaminophen (Tylenol).

It is essential for people to follow the instructions on the packaging, and to check with a doctor about possible interactions with other medication that the drugs may have.


Some people with a headache on the top of the head find relief from diet changes. Caffeinated drinks such as coffee or tea may help, but other people might find relief from drinking water. Eating a light snack may also help.

Self massage

A self-massage can sometimes relieve tension in the head and neck.

Massaging the muscles on the side of the neck and back of the head and the muscles along the jaw line, could reveal a tight area that is causing the pain. The tension can be released, and the headache can be relieved with a regular gentle massage of these areas.

Lifestyle choices

Some people may find simple lifestyle tips help, including:

  • reducing stress levels with breathing exercises or yoga
  • getting more sleep
  • maintaining good posture
  • seeing a physical therapist or massage therapist
  • getting regular acupuncture sessions

Takeaway and when to see a doctor

Anyone with a headache that continues after home treatments should see a doctor who may help identify triggers, and suggest lifestyle changes or stronger medications.

Severe headaches should be reported to a doctor for a diagnosis. It is important to be aware of the possibility of a more serious complication, although these problems are not as common as other factors.

Symptoms that confirm a need to see a doctor include:

  • major changes in the patterns of headaches
  • severe or persistent headaches or ones that get worse over time
  • headaches that develop in older age
  • headaches accompanied by pain near the temples
  • pain that gets worse with movement or coughing
  • changes in mental ability
  • mood swings
  • headaches after hitting the head
  • headaches that prevent normal functioning
  • headaches that wake a person up
  • headaches in people with impaired immune systems or cancer

Other signs include:

  • stiff neck
  • fever
  • fatigue
  • decreased mental alertness
  • slurred speech
  • numbness
  • seizures
  • blurred vision

Anyone experiencing these symptoms should seek medical care and a professional diagnosis. Given a proper diagnosis and the right treatment, many people can find relief from a headache on the top of the head.