Headache on Top of Head: 9 Possible Causes

There is no certain reason why you feel pain at a certain place in your head. Different people experience different types and intensities of headaches in different places. Likewise, a headache on top of the head can mean a lot of things. Thus, for every person, there might be different triggers, symptoms, and causes, which may suggest what is going on inside your head. There are several types of headaches where you feel pain on top of your head.

  1. Migraine
  2. Cluster headaches
  3. Tension headache
  4. Headache due to lack of sleep
  5. Exercise headache
  6. Ice pick headache
  7. Post traumatic headache
  8. Hypertension headache
  9. Chronic headaches

1- Migraine

Migraine is characterized by severe throbbing pain experienced mostly in half of the head, but can also be felt on top of the head, back of the head, and whole head.


  • Nausea
  • Vomiting
  • Loss of coordination
  • Ringing in ears
  • Sensitivity to light, noise, and smell

Triggering factors

For every individual, there are different triggers that lead them to a migraine attack. But some of the triggers as identified by doctors are:

  • Stress
  • Change in sleeping pattern
  • Irregular dietary habits
  • Hormone changes
  • Tobacco and other strong odors
  • Processed foods
  • Chocolate
  • Aged cheese.


Migraine begins when overactive nerve cells send out signals to the trigeminal nerve-a nerve that supplies sensation to our head and face, activation of this nerve cause release of certain chemicals which cause blood vessels in the scalp of our brain to swell up, a process called vasodilation, this releases excess neurotransmitters that can cause inflammation and sensation of pain.


  • Over-the-counter analgesics can sometimes help a migraine attack. Lying down in a dark room also proves very helpful in managing the symptoms.
  • Excedrin is a drug that is used for the treatment of migraine headaches.

2- Cluster headaches

Cluster headaches are identified by their cyclic pattern of repetition. This may occur almost daily at the same time for a week and sometimes even more than that. The pain is generally located at the forehead, behind the eye, on one side of the head, and on top of the head and is most severe for 5 to 10 minutes after it starts lasting up to 2 to 3 hours.


  • Sharp pain and pressure in the head and behind the eyes
  • Watery or swollen eyes
  • Nasal congestion and discharge
  • Agitated or restless feeling.


Some of the probable causes are

  • Sleeping disorders like insomnia
  • Smoking
  • Alcohol.

You might also experience cluster headaches if you’ve had a head injury. Talk to your physician in this case and begin treatment as soon as possible.


Subcutaneous injection of sumatriptan and inhalation of 100% oxygen is helpful for an acute attack while lithium therapy under observation and monitoring by a health physician is advised for chronic attacks.

3- Tension headache

As suggested by the name, a tension headache is triggered due to stress or tension building up in your muscles due to an inappropriate posture or because of anxiety that tenses up the muscles in your neck, shoulders, face, jaw, and scalp.

Tension headaches are generally felt as a sense of building pressure in the form of a band around the head which begins usually in the occiput and radiates forward and causes headaches on top of the head in some cases.


  • Dull pain or sensation of growing pressure around the head
  • Pain behind eyes
  • Pain in the temples
  • Tenderness over the skull vault and headache on top of the head
  • Tenderness at the occiput
  • Mood and sleep disturbance.


  • Stress
  • Anxiety
  • Depression


  • Warm compressions at the back of the neck, a hot shower, or a simple analgesic can help prevent a tension headache.
  • Over-the-counter painkillers are proven to be an effective treatment.

4- Headache due to lack of sleep

Waking up with a headache on top of the head, back of the head, or forehead is one major sign that you did not get enough sleep. There are several types of headaches due to lack of sleep with their associated symptoms to differentiate them from each other.


  • Fatigue
  • Mild Nausea
  • Photophobia and phonophobia
  • Low mood
  • Irritability
  • Dizziness
  • Lightheadedness.


  • One reason is the formation of proteins in the body that cause chronic pain due to lack of sleep. These proteins work by lowering the body’s pain threshold thus, sparking intense migraines and headaches.
  • Several studies indicate that lack of REM (rapid eye movement) sleep causes more painful headaches.


  • Analgesics: Aspirin, acetaminophen, ibuprofen
  • Excedrin: For a migraine attack
  • Triptans: For Tension Headache
  • Antiemetics: Chlorpromazine, metoclopramide

5- Exercise headache

Exercise headaches are triggered by some sort of physical activity, ranging from a swift walk to strenuous exercise, person to person. It is usually felt on both sides of the head but is also felt on one side of the head and the top of the head.


  • Nausea and vomiting
  • Lethargy
  • Congestion
  • Neck stiffness
  • Blurred vision.


The muscles of your head, neck, and scalp require more blood to meet its oxygen requirements while you are working out. This leads to vessel dilation in the blood vessels of the head leading to a headache.


A primary headache is usually benign and mostly responds to over-the-counter analgesics. Indomethacin is the most commonly prescribed drug for an exercise headache. This is usually taken 30 mins to an hour before exercise.

6- Ice pick headache

Ice pick headache is a sharp, intense pain that lasts for a brief duration. This can generally occur in any part of your head, most commonly around the eyes, temples, and on top of the head. This can be one of the most painful headaches ever experienced.


The duration is so brief that there is no time for other associated symptoms to show up. However, some of the symptoms include:

  • Feels like stabbing with the spokes of ice
  • Abrupt onset of a stabbing, throbbing headache
  • Duration lasting only 5 to 10 seconds
  • The pricking occurs several times during the day.


The exact cause is still unknown but some physicians consider this to be associated with disruptions in the control mechanisms of the brain, for a brief duration of time. Ice pick headache occurs in primary and secondary forms.

Primary: This occurs without any apparent cause and the headache itself is the cause.

Secondary: There are some underlying conditions such as multiple sclerosis, bell’s palsy, herpes zoster, etc.


Melatonin: Usually given as a treatment for insomnia and insomnia-triggered headaches.

Indomethacin: is a non-steroidal anti-inflammatory drug (NSAID) that reduces inflammation and helps relieve pain.

7- Post traumatic headache

People who experience any sort of traumatic injury to their head or neck often come up with the complaint of a Headache, known as post-traumatic headache. The pain location usually varies in individuals depending upon the type and region of injury but is commonly experienced on top of the head and back of the head.


  • Throbbing headache like migraines
  • Insomnia
  • Concentration problems
  • Decreased reaction time
  • Anterograde amnesia.


There can be a number of causes:

  • Concussion
  • Hemorrhage
  • Imbalance of neurotransmitters
  • Swelling of brain structures
  • Shrinkage of brain.


  • Anti-Inflammatories: Aspirin, acetaminophen.

If the headache persists, your doctor will put you on preventive treatment, i.e.

  • Anti-hypertensives: B-blockers, calcium channel blockers.
  • Anti-depressants: SSRIs.
  • Anti-psychotics: Clozapine, risperidone.

8- Hypertension headache

There is characteristic pulsating pain on the top of the head due to high blood pressure which gets worse on exerting. Headache on top of the head is caused by disturbance to the blood-brain barrier due to increased blood pressure causing the leakiness of blood vessels in the brain.

If the blood pressure exceeds 180/120, one can also experience nosebleeds and go into a hypertensive crisis which is a medical emergency and may end up in an emergency room. Hypertension headache require immediate medical attention.

9- Chronic headaches

If you suffer from a headache 15 or more days a month for at least three months, this classifies as a chronic headache and needs special medical attention, which includes booking an appointment with your physician as soon as possible. This is more commonly observed in cluster headaches, tension headaches, migraine, and different types of migraine.

This needs special lifestyle modification including dietary changes, better sleep, hydration, and limiting alcohol.

When to consult a doctor?

If the frequency of headaches keeps on increasing and is making you take analgesics more than 15 times a month, consult a doctor.


Why do you feel a headache on top of your head?

Different people experience different types and intensities of headaches in different places in their heads. Likewise, pain at the top of your head can mean a lot of things. Thus, for every person, there might be different triggers, symptoms, and causes, which may suggest what is actually going on inside your head.

Why do I feel pain on the top of my head after working out?

Some people have reported throbbing headaches on the top of their heads after strenuous exercises like biking, weightlifting, running, cardio training, and sometimes even sex. An understandable cause for exertional headache is pressure on the blood vessels in the brain when you are exerting. They can start during or after the physical activity and may last anywhere from a few minutes to a day or two.

I had a severe headache that led to a nosebleed, what was that?

Headache associated with hypertension is a throbbing, pulsating pain that can aggravate into nosebleeds If the blood pressure exceeds 180/120. Patients might go into a hypertensive crisis which is a medical emergency and may end up in an emergency room. Hypertension headaches require immediate medical attention.

Every time I have a headache, there is a temporary loss of vision, what is that?

Migraines with auras are a less common type of migraine. These headaches are accompanied by Auras, which come up as warning signs 15 to 20 minutes ( in some cases) a day before migraine and include visual symptoms, phonophobia, photophobia, temporary loss of vision, nausea, and change in taste and smell.

Why do I feel a sharp, stabbing pain in my head on the first bite of ice cream?

This pain is a result of vasodilation and a sudden rush of blood from your brain to the roof of your mouth in response to the excitation of the trigeminal nerve as something cold hits your palate (roof of the mouth), particularly on a hot summer day. This is known as a cold stimulus headache.

Last medically reviewed on October 1, 2022.