Tension headache at the lower back of the head

Tension-type headache may cause pressure or aching around the base of the skull, with tightness extending into the neck and shoulders. Desk work, driving, sleeping with the neck in an awkward position, stress, and prolonged muscle contraction can contribute. Tender muscles do not prove that the pain is a tension headache. Irritated nerves, migraine, infection, injury, and other causes can produce pain in the same region, so changes in pattern deserve attention.

Adjust your chair and screen so your head is balanced over your shoulders, change position regularly, and make slow, comfortable neck movements. A warm compress may relax tight muscles if it feels soothing. Keep meals, fluids, and sleep as regular as possible. Write down the start time, duration, neck movement, recent injury, and any arm symptoms. Follow label directions for any over-the-counter medicine and seek a GP consultation when the problem keeps returning or does not improve.

Seek urgent care for a sudden explosive headache, severe pain after a fall or blow, new weakness or numbness, confusion, trouble walking or speaking, fainting, seizure, fever with a stiff neck, or repeated vomiting. New severe headache with vision loss is also an emergency. If pain gradually worsens, spreads into an arm, or limits neck movement, arrange prompt medical assessment even without those emergency features.

Ask whether your neck posture, muscles, nerves, medicines, or another headache type could explain the symptoms. Tell the clinician about injuries, work habits, sleep position, and any pain, tingling, or weakness in your arms.