What is the Cause of Headache at the Base of the Skull?

Headaches at the base of the skull can be caused by several underlying conditions including muscle tension, stress, poor posture, and more. The most common causes of headaches at the base of the skull are related to muscular tension, often caused by a buildup of stress and anxiety. Additionally, poor posture or an improper sleeping position can also be the underlying cause of such headaches.

This article will provide an overview of the causes of headaches at the base of the skull and how the symptoms can be addressed:


Definition of headache at the base of the skull

Headache at the base of the skull is often referred to as occipital neuralgia, which is a type of headache that occurs when the occipital nerves become irritated or damaged. The occipital nerves are located at the back of the head and travel into each side of the upper neck region. The pain can be either intermittent or constant, and it may feel like an electrical shock or a dull ache in affected areas.

Occipital neuralgia is usually caused by trauma or postural issues such as prolonged sitting with poor posture, neck injuries, muscle strain, whiplash, arthritis, tight neck muscles, and nerve compression from a tumor or injury. Other causes may include problems with blood vessels in the back of the head, diseases such as diabetes, infection, or inflammation around nerve endings due to viral or bacterial infection.


Headaches at the base of the skull can have multiple causes. These headaches can be due to tension, migraine, or nerve issues, as well as a variety of medical conditions. They can be caused by stress, poor posture, bad sleeping habits, eye strain, neck pain, or other physical exertion.

Let’s look into each of these potential causes in more detail:


Stress is one of the most common causes of headaches at the base of the skull. A tension headache affects both sides of the head, as well as the base of the skull, and may cause aching or pressure sensations. Constant stress can increase muscle tension in your neck and head. Additionally, changes in sleep patterns due to stress can affect the level of cortisol in your system and increase your vulnerability to headaches.

People may reduce their stress levels by taking care of themselves through:

  • Exercise
  • Getting enough rest
  • Eating healthily
  • Engaging in relaxation activities
  • Seeking counseling when necessary.

Poor posture

Poor posture can be a major cause of headaches at the base of the skull. Many times, people sit for long periods without ever changing posture or slouch when sitting, which can put excess pressure on the neck and muscles at the base of the skull. Over time, poor posture can lead to strain in these areas and trigger tension headaches.

Long-term studies have shown that repeated episodes of bad posture can also strain ligaments in the neck and aggravate muscles around it, leading to painful muscular tension in this area. The discomfort from this kind of postural stress is often felt as a diffuse headache that begins at the base of the skull.

To prevent headaches caused by poor posture, it’s important to ensure that you are sitting in an ergonomic chair with good lumbar support and to maintain a comfortable workstation layout where needed items are within reach, reducing strain on your arms and shoulders. Additionally, taking regular breaks throughout your day to stretch or walk around is recommended so that you avoid extended episodes of maintaining an unnatural position or status quo. Good neck exercises can be very beneficial as well.

Muscle tension

Headaches at the base of your skull may be caused by muscle tension. This is especially true if you are under stress don’t get enough regular exercise or have bad posture when sitting. Muscle tension headaches usually start at the base of the neck and then spread up over the top of your head on both sides towards the base of your skull. They can be mild to severe in intensity, often throbbing. The pain may become worse when you move your head or neck and may last for several hours or more.

Other causes of headaches at the base of your skull include:

  • dehydration
  • excessive caffeine intake
  • alcohol use
  • sinus infections
  • allergies
  • colds and flu-like illnesses

It’s important to speak to your healthcare provider if you experience frequent headaches as unresolved headaches can lead to more serious issues.

Cervicogenic headache

Cervicogenic headache is a type of headache that originates from disorders in the cervical joints, muscles, and nerves. Cervicogenic headaches usually cause pain on one side of the head, although they can occur on both sides. The pain can also radiate to other areas such as the neck and shoulders, and even downwards to the arms or skywards to the eyes.

Cervicogenic headache is primarily caused by exaggerated motion or sustained postures in the neck which leads to muscle tension and irritation of various nerve endings located in this area. These nerve endings convey a pain signal to other parts of the head, causing radiating sensations experienced as a headache.

Common causes of cervicogenic headache include:

  • Muscle strain due to poor posture (e.g., sitting at a desk for long hours).
  • Trauma such as whiplash during an auto accident.
  • Certain disorders such as degenerative disc disease or arthritis.

Other factors such as stress, fatigue, and alcohol consumption may further aggravate this type of headache by increasing muscle tension and spasms in this area.

Medication side effects

Headaches at the base of the skull can be caused by medication side effects. Certain drugs that are used to treat conditions, such as hypertension, depression, migraine, and painkillers, can cause peripheral muscle tension headaches in some people. This type of headache typically has a tight band-like sensation around the base of the skull and radiates up the sides of the neck.

If you have recently started taking a new medication and you experience a headache at the base of your skull that gets worse over time, contact your doctor immediately as this could be an adverse reaction to the medication. Additionally, discuss any other medications or supplements you are taking as they too could increase your risk of getting this type of headache.


When diagnosing the cause of headache at the base of the skull, it is important to consider the patient’s medical history and current symptomology. A comprehensive physical exam, including tests such as X-rays, MRIs, and CT Scans, may be necessary in order to accurately assess the source of the pain. Additionally, blood tests may also be necessary in order to check for inflammation and infection.

Let’s take a closer look at common diagnostic tests and treatments:

Physical examination

Physical examination is an important part of diagnosing the cause of a headache at the base of the skull. Your doctor will review your medical history, ask about your symptoms, and conduct a physical examination to assess any tenderness or swelling near the neck and skull. Additionally, your doctor may order imaging tests to diagnose possible causes of your headache such as a CT scan, MRI, or X-ray.

Each physical exam will vary, but commonly includes:

  • Measuring head circumference and any visible abnormalities
  • Inspecting for signs of neck muscle tightness or tenderness
  • Testing eye movements to evaluate cranial nerve function
  • Checking sensitivity by pressing on parts of the head, face, and shoulder areas
  • Testing muscle strength in the upper extremities
  • Checks for balance abnormalities which can point toward vestibular system issues

If no major findings result from performing these tests, then further investigation may be necessary to determine if there is an underlying medical condition causing headaches at the base of the skull.

Imaging tests

Imaging tests can be used to determine if a mass, tumor, or other abnormality is causing your headache at the base of your skull. Common imaging tests used to diagnose the cause of headaches are:

  • X-rays – Uses radiation to image bones and soft tissues such as organs, muscles, and blood vessels.
  • CT (computerized tomography) scan – Takes multiple X-ray views from different angles to create images of structures inside the body.
  • MRI (magnetic resonance imaging) scan – Uses a powerful magnet and radio waves to create detailed images of structures inside the body.
  • Ultrasound – Uses sound waves to create images of soft tissues and organs, including the brain and heart.
  • MRA (magnetic resonance angiography) – A type of MRI that provides detailed images of blood vessels in specific areas, including those in the head.

Your doctor will consider these imaging tests depending on your symptoms and any other conditions that may increase your risk for certain types of complications or disorders associated with headaches at the base of your skull.

Blood tests

A clinical diagnosis is essential to find the root cause of your headache at the base of your skull. Generally, a physical exam, imaging tests, and blood tests are used to identify the source. Blood tests can measure levels of hormones, markers of infection and inflammation, and levels of vitamins and minerals like calcium, magnesium, and iron. Tests may also look for evidence that could indicate a disorder such as diabetes or an accident that caused head trauma. Your doctor may order additional studies if other symptoms or abnormal results are present.

Blood tests can assess whether fatigue is related to anemia from a low red blood cell count (resulting from inadequate iron absorption), a sign of nutritional deficiency caused by poor diet. It can also identify deficiencies in trace elements such as copper which could explain why headaches may occur due to magnesium deficiency in some patients. From these results, factors likely impacting upon daytime brain fog can be narrowed down and assessed further so that an accurate diagnosis can be made.


When it comes to treating headaches at the base of your skull, the goal is not only to alleviate the pain but also to identify and treat the underlying cause. The treatment plan may involve lifestyle modifications, medications, physical therapy, or in some cases, surgery.

In this section, we will explore some of the most effective treatments for this type of headache:

Pain relievers

Pain relievers are typically the first line of treatment for headaches at the base of the skull. Over-the-counter medications include ibuprofen, aspirin, and acetaminophen. If your symptoms are severe or do not improve with regular over-the-counter medications, stronger medication may be recommended. Prescription medications such as narcotic pain relievers and muscle relaxants may be prescribed to provide relief from more severe head pain.

It is important to note that although over-the-counter and prescription medications can help relieve the pain of a headache at the base of the skull, prolonged use may lead to further complications, such as rebound headaches or medication overuse headaches. Additionally, some people may have an adverse reaction to certain medications so it is important to consult your doctor before using any medications for extended periods of time.

Nonmedication treatments such as

  • physical therapy
  • acupuncture
  • massage therapy

can also help treat headaches at the base of the skull by reducing muscle tension in this area and promoting relaxation. Some doctors may recommend lifestyle changes such as

  • getting adequate sleep
  • drinking plenty of fluids throughout the day

to help prevent or reduce symptoms of a headache at this part of the head.

Physical therapy

Physical therapy is a popular approach for treating headaches at the base of the skull. This form of treatment involves techniques to reduce pressure and pain created by tight muscles in the neck and shoulder area. Physical therapy can include:

  • Manual therapies such as massage, trigger point release, or deep tissue work to reduce muscle tension or spasm.
  • Postural awareness techniques to change habits that make symptoms worse.
  • Exercise programs tailored to the individual’s needs to strengthen postural and neck muscles.
  • Stretching and relaxation techniques tailored to the individual’s needs to decrease head and neck stiffness while promoting improved flexibility and range of motion.
  • Neuromuscular reeducation exercises aimed at restoring ideal movement patterns with correct posture throughout daily activities, as well as regular exercise routines.
  • Heat/cold therapies can be used for increased relaxation or pain relief if necessary.

Stress management

Headaches located at the base of the skull can be caused by stress. To reduce muscle tension at the base of your skull, tension-reducing techniques such as progressive muscle relaxation, yoga, or deep breathing exercises may be beneficial.

In addition to lifestyle changes and relaxation techniques, medications may also be used for the treatment of tension headaches that occur at the base of your skull. Over-the-counter medications such as ibuprofen or acetaminophen can help reduce pain and inflammation from stress and headache discomfort. However, if lifestyle treatments and over-the-counter medications are not effective in providing relief, a physician may prescribe stronger medications or muscle relaxants tailored to each individual’s needs.

Cognitive behavioral therapy (CBT) may also help reduce stress levels that lead to headaches at the base of the skull. CBT is an evidence-based treatment option focused on identifying specific thoughts and behaviors that contribute to increased levels of anxiety or stress in order to learn more adaptive ways of reacting. It’s important to speak with a healthcare provider if you believe you are experiencing frequent tension headaches associated with mental health issues in order to find an appropriate course of treatment.


Acupuncture has been considered as a viable treatment for headaches, particularly those originating at the base of the skull. During an acupuncture session, a licensed acupuncturist carefully places thin needles into specific points on the body to alleviate pain and tension. This ancient form of Asian medicine, which originated in China over 5000 years ago, is based on energy pathways called meridians that course through the body. If these pathways become blocked due to injuries, stress, or other factors, pain and tension can result.

Acupuncture works by releasing endorphins and other natural chemicals which act as natural painkillers. The needles stimulate nerve pathways located beneath the surface of the skin and encourage greater balance in the circulation of fluids such as lymphatic secretions throughout the body. It has also been credited with improving overall levels of stress in the body while promoting better sleep and relaxation.

The goal of acupuncture is to improve health not just by addressing symptoms but also by alleviating their causes which gives it a higher success rate than conventional treatments alone. Treatments vary based on individual needs with patients typically coming in two or three times a week until they notice an improvement in their symptoms.


Headaches can be caused by a variety of factors including stress, physical or emotional tension, environmental factors, and even certain foods. One way to prevent headaches at the base of your skull is to reduce your stress and tension levels. This can be done through relaxation techniques such as yoga, meditation, or by taking frequent breaks throughout the day.

Additionally, lifestyle modifications such as regular exercise, reducing alcohol or caffeine intake, and getting adequate sleep can also be beneficial.

Maintain good posture

Maintaining good posture is essential for keeping your spine in its natural alignment and reducing tension in the neck muscles. Looking down at a phone, tablet, or computer for excessive amounts of time can cause improper posture, resulting in neck strain and headaches at the base of the skull. To avoid misaligning your posture, be sure to:

  • Stand with your feet shoulder-width apart and your weight equally distributed
  • Try to keep your elbows resting comfortably at your sides
  • Roll up your shoulders so they are straight and not hunched
  • Keep your chin pulled in, and tuck it inward ever so slightly as if there were a string connected to the top of your head pulling you upward.

When sitting down or lying down, use cushions or a rolled towel to support proper alignment. Be sure to sit up straight with your lower back against the backrest; avoid leaning forward or slouching. If you are on an airplane, adjust the headrest to properly support your neck and shoulders while traveling long distances.

Exercise regularly

Regular exercise has numerous benefits for overall health, and it can help to reduce the occurrence of headaches. By creating a consistent routine, blood circulation will improve and oxygen will be delivered to all areas of the body effectively. Exercise helps to relieve stress from day-to-day living and relaxes muscles, making them less prone to spasms. It releases hormones that elevate the mood and boost energy, which can also lead to a decrease in headaches.

When exercising for headache prevention, it’s important to choose activities that are safe and maintain a moderate intensity without pain or overexertion. Aerobic exercises are best suited for this purpose. Some excellent choices include:

  • Brisk walking or jogging
  • Swimming
  • Cycling
  • Cardio machines at the gym such as elliptical trainers and stair steppers.

Bodyweight exercises like yoga or Pilates can also help with headache prevention by strengthening core muscles in the neck and upper back that support proper posture.

Get enough sleep

Getting adequate sleep is an important step in creating an overall lifestyle of good health and wellness. Insufficient or disrupted sleep can lead to a number of issues, including headaches at the base of the skull. Most adults need seven or eight hours of sleep every night. The quality of sleep is just as important as the duration; make sure you are getting enough uninterrupted rest so that your body has time to physically and mentally recharge.

Developing a consistent evening routine that includes winding down an hour before bedtime can help set yourself up for success in getting a sufficient amount of quality rest every night. It may be helpful to turn off electronic devices at least 30 minutes before bed to help relax both your mind and body for optimal restful sleep.

Reduce stress

A headache at the base of the skull could have a number of possible causes and, therefore, require an in-depth medical assessment. Nevertheless, one of the best ways to prevent a headache at this location is to reduce stress. Stress relief can be achieved through various non-medical activities such as regular exercise, meditation, or other relaxation techniques.

Adopting conscious habits on a daily basis can help people keep their stress down and maintain overall well-being.

  • Regular physical activity
  • Yoga or tai chi classes are designed to help quiet the mind while calmly stretching and strengthening the body.
  • Taking regular timeouts during the day – these consist of sitting quietly for a few minutes and focusing on deep breathing.
  • Other types of physical activities that are helpful for reducing stress include walking, jogging, dancing, or spending time in nature.
  • Maintaining good sleeping habits helps manage high levels of daily stress by giving the body enough rest in order to restore its energy reserves and remain healthy on all levels.

Frequently Asked Questions

A headache at the base of the skull can be a symptom of a variety of medical conditions, including tension headaches, migraines, and cervical spondylosis (a condition that affects the neck and upper back). In some cases, the headache may also be caused by sinus or ear infections, or a pinched nerve in the neck or shoulder. It is important to speak to a healthcare provider to determine the underlying cause of the pain.

Neck pain at the base of the skull can be caused by a variety of factors. Muscular tension and strain, pinched nerves, poor posture, and overuse can all contribute to neck pain at the base of the skull. Additionally, medical conditions such as whiplash, cervical spondylosis, and spinal stenosis can cause neck pain in this area. To receive a proper diagnosis and treatment plan, it is important to see a medical professional.

Pain in the back of the head is often caused by tension headaches, which are caused by muscle tension in the neck and scalp. Other potential causes of pain in the back of the head include migraines, infections, and injury.

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