Here's how the location of headache can—and can't—help you evaluate your overall health.

By Blythe Copeland
January 25, 2021
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Not sure whether that throbbing in your head means you had one glass of wine too many or that you need to see a doctor as soon as possible? Though the location of the pain can't tell you everything about your headache (or its cause), it can offer a few clues. Ahead, a neurologist shares everything there is to know about mapping that pain in your skull.

woman with a headache
Credit: Getty / Westend61

You can't always trust your pain.

The location of your headache isn't a guaranteed way to pinpoint its cause, says Dr. Katherine Hamilton, neurologist from Penn Medicine, because of the way your brain processes information. "Sometimes you can be misled by the location of pain, because it doesn't always accurately reflect the underlying cause of the headache," she says. "The pain signals from the entire head and neck region all converge in one area of the brain, the brain stem. Because all of the input comes into this one area, there can be a crossing of signals, so an issue going on in one part of the head and neck can be interpreted as pain in a separate area—for example, an issue going on in the upper neck region can be perceived as pain behind the eye." But the location of your headache can give you other important information about what's going on—and how to treat it, she says.

There are two main types of headaches—and location does matter when identifying them.

Most headaches fall into one of two categories—tension or migraine—and the location of your pain is one tactic for distinguishing between them. "Tension type headaches tend to be more mild, are on both sides of the head, and are often described as dull pressure or a band around the head," says Dr. Hamilton. "Migraines tend to overall be more severe." They're typically one-sided and culminate in a more throbbing, pulsing pain—and have other unfortunate symptoms, like nausea or light sensitivity, she says. And while there is a third type, it's far less common: Cluster headaches always happen on the same side of the head, behind your eye.

Common triggers of tension headaches and migraines include dehydration, illness, not getting enough sleep, hormonal changes, skipping meals, and stress—but those don't cause a headache in one specific location. "When we're diagnosing headaches, we take into account triggers," says Dr. Hamilton, "but there's not a headache due to dehydration specifically, or a headache due to sleep deprivation—those would be lumped into the migraine or tension-type."

Head pain has other causes.

Not all head pain is diagnosed as a tension headache or migraine, though, and in those cases, the location can offer important information about other causes—like muscle tension, nerve pain, or jaw issues. "Oftentimes, headaches related to muscle tension can cause pain in certain areas," notes Dr. Hamilton. Dull pain by your temples, especially when you wake up in the morning, could indicate teeth clenching or TMJ; a headache in the back of your head and along your neck may be related to neck tension or a cervical spine issue. Nerve irritation can also cause pain in one spot: "There are different nerves around the head, and if you're having a specific type of pain over a focal area, that can be indicative of irritation of the local nerve," she adds. "For example, there are big nerves in the back of the had called occipital nerves, and sometimes those can get irritated and present with sharp shooting pains in the back if the head. If the pains really are limited to that distribution of the nerve, that can be a sign of local irritation."

Know when to see a doctor.

Pain in a certain location isn't an indication that you need to head to the emergency room immediately, says Dr. Hamilton; rather, consider the severity and frequency of your headaches, as well as any sudden onset of intense pain. "The features of the headache, like how quickly it came on, the pattern of headaches, whether there are any neurological abnormalities—those things tend to be more important in determining whether or not to be concerned about a more dangerous underlying cause," explains Dr. Hamilton. Keeping a diary can help you identify any consistent activities that happen before a headache—too much coffee, hours of looking down at your laptop, a long car ride—which is a helpful step toward mitigating the causes. Ice, heat, and anti-inflammatory over-the-counter medications should help most head pain, she says, but if you are treating headaches multiple times each week, it may be time to call your doctor.

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