Where a headache sits gives a useful clue to its type, though no location is proof on its own. Pain at the back of the head often comes from the neck. Pain behind one eye suggests migraine or cluster headache. A band around the head suggests tension-type headache. Pain across the forehead and cheeks suggests sinus involvement.
The map below covers the eight places headaches usually settle.
Headache location meaning at a glance
Find the row that matches your pain. Treat it as a starting point, not an answer.
| Where it hurts | What it usually feels like | Most likely type | Common triggers |
|---|---|---|---|
| Back of the head, base of the skull | Deep ache, or sharp pain shooting up the scalp | Cervicogenic, or occipital neuralgia | Desk posture, sleep position |
| One side, behind or around one eye | Throbbing, or severe boring pain in bouts | Migraine, or cluster headache | Missed meals, poor sleep, alcohol |
| Both sides, like a band | Steady pressing, mild to moderate | Tension-type headache | Stress, screen time, clenching |
| Forehead and across the cheeks | Dull pressure, worse bending forward | Sinus-related, or migraine mistaken for sinus | Colds, allergies, weather |
| Top of the head | Heavy pressure on the crown | Tension-type, or cervicogenic | Stress, neck strain, poor sleep |
| Temples, one or both | Tight ache, or one-sided throbbing | Tension-type or migraine. Over 50, consider giant cell arteritis | Clenching, chewing, stress |
| Whole head | Constant dull ache, most days | Tension-type, medication overuse, or systemic | Daily painkillers, dehydration, infection |
| Behind both eyes, with the jaw | Eye pressure with jaw ache or clicking | Jaw muscle overactivity referring pain | Clenching, grinding, chewing |
Back of the head and the base of the skull
Pain that starts at the base of the skull and spreads up or forward is often cervicogenic, meaning it begins in the upper neck joints and is felt in the head. It is usually one sided, and steady rather than throbbing. When the pain is instead sharp, electric and shooting up the back of the scalp, occipital neuralgia (irritation of the nerves running from the neck over the scalp) is more likely. Our post on headaches that start in the neck covers how both are confirmed and treated.
One side, behind or around one eye
Pain focused behind or around one eye points to migraine or cluster headache. Migraine throbs, builds over minutes to hours, and brings nausea with sensitivity to light and sound. Cluster headache is different, and frequently misidentified. It is severe, strictly on one side, and comes in bouts lasting weeks, with attacks at similar times each day. Each attack is much shorter than a migraine, and often brings a watering eye, a drooping lid, or a blocked nostril on that side. People call it boring or piercing, not throbbing.
A band around both sides
A steady band of pressure around both sides of the head, as though a hat is too tight, is the pattern of tension-type headache, the most common type. It presses rather than throbs, stays mild to moderate, and does not usually worsen with walking or stairs. Nausea is unusual. Episodes often follow long screen sessions, stress, poor sleep, or jaw clenching. Many people find they ease with rest and gentle neck movement. When they happen on most days of the month, the cause is worth investigating.
Forehead and across the cheeks
Pressure across the forehead and over the cheekbones, worse when you bend forward, points toward sinus involvement, especially alongside a cold, thick nasal discharge or a fever. Here is the honest part: migraine is very often mistaken for sinus headache. Migraine can produce facial pressure, a blocked or runny nose, and watering eyes, because the nerves supplying the face and sinuses take part in the attack. If facial headaches keep returning without infection, and antibiotics have made no difference, migraine is the likelier explanation.
The top of the head
Pain on the crown, usually described as a weight pressing down, tends to be tension-type headache or pain referred from the upper neck. It builds slowly through the day and often settles with rest. Less commonly, pain confined to the top of the head relates to irritation of a nerve higher in the scalp. On its own, top-of-head pain rarely signals anything serious. What matters is the company it keeps: if it arrives suddenly, wakes you from sleep, or comes with any change in vision, speech or strength, it needs assessment.
The temples, one or both
Aching in both temples is usually tension-type headache. Throbbing in one temple, with light sensitivity or nausea, is more often migraine. The temple also sits over a jaw muscle, so clenching and chewing can set it off. One pattern needs urgent attention. In anyone over 50, a new headache with scalp tenderness (painful to brush your hair or rest on a pillow) and jaw pain that comes on while chewing can indicate giant cell arteritis, inflammation of the arteries at the temples. That needs same-day assessment.
The whole head
A dull ache spread across the whole head, present on most days, has three common explanations. Tension-type headache is the first. Medication overuse headache is the second, and it is covered next. The third is a systemic cause: dehydration, a viral infection, broken sleep, or alcohol. Note how many days a month the pain is there, because that number shapes the answer. Whole-head pain building steadily over weeks, or clearly worse when lying flat, belongs with a doctor promptly.
Behind both eyes, with the jaw
Pressure behind both eyes that arrives with jaw ache, clicking, or a tight face in the morning usually comes from overactive jaw muscles. The muscles that close the jaw run up the side of the head, and they refer pain forward into the eyes and temples. Clenching or grinding at night is a common driver, so people wake with the jaw and the head already sore. Treating the jaw changes this pattern. Our post on lasting relief for TMJ pain sets out the options.
When the painkillers are keeping the headache going
Taking painkillers for headaches on more days than not can, over time, sustain a near-daily headache of its own. This is medication overuse headache. It is common, under-recognised, and easy to miss, because each tablet still helps for a few hours before the pain returns. The answer is not a stronger tablet. It is a planned reduction, supervised by a doctor, usually with preventive treatment arranged to cover the gap. Raise it at your next appointment rather than stopping abruptly on your own.
What the pattern adds to the location
Location narrows the field. Pattern usually decides it. Note five things before an appointment. How fast it comes on: seconds, minutes or hours. How long it lasts: half an hour, a full day, or three days. What it feels like: throbbing with each heartbeat, or steady pressing. Whether it switches sides between attacks, which points away from a fixed structural cause. And what comes with it: nausea, light sensitivity, a watering eye, a stiff neck, or visual changes.
What a headache assessment involves, and what a pain clinic adds
An assessment starts with the story: where the pain sits, how often it comes, how long it lasts, what sets it off, and what you have already tried. An examination checks the neck, the jaw, the scalp nerves and your neurological signs. Scans are used only when that picture calls for one.
An interventional pain clinic adds procedures aimed at the source. Botox for chronic migraine is an established option for people with headaches on many days each month. Occipital nerve blocks target the scalp nerves at the back of the head. When the neck is the suspected source, a diagnostic block comes first: local anaesthetic is placed at one specific neck joint, and if the headache eases briefly, that joint is confirmed as the source. Radiofrequency ablation can then interrupt that nerve’s signal for longer. Sharp electric facial pain is assessed separately, since trigeminal neuralgia is managed differently.
Red flags: when a headache needs urgent care
Go to an emergency department or call 911 if you have:
- the worst headache of your life, or one that peaks within seconds
- headache with a fever and a stiff neck
- headache after a head injury
- headache with new weakness, numbness, slurred speech, confusion or loss of vision
- new scalp tenderness with jaw pain when chewing, if you are over 50
- headache that is worse lying down, or that wakes you from sleep
- a headache pattern that suddenly changes in site, severity or frequency
- a new headache if you have cancer or a weakened immune system
These are uncommon, but timing matters. Do not wait to see whether it settles.
Frequently asked questions
What does the location of a headache tell you?
It narrows the likely type without confirming it. The back of the head points to the neck, behind one eye to migraine or cluster headache, a band to tension-type headache, and the forehead with the cheeks to sinus involvement or migraine. Timing and the symptoms alongside it decide the rest.
What does a headache at the back of the head mean?
Most often it comes from the upper neck joints, which refer pain into the back of the head. Desk posture, sleep position and neck strain are common drivers. If the pain is sharp and electric and travels up the scalp, irritation of the occipital nerves is more likely.
Where is a migraine headache usually felt?
Classically on one side, behind or around the eye or at the temple, throbbing and building over minutes to hours. It can affect both sides, and it can switch sides between attacks. Nausea and sensitivity to light and sound separate migraine from tension-type headache.
How do I tell a sinus headache from a migraine?
True sinus headache usually comes with an infection, a fever and thick nasal discharge, and it clears as the infection does. Migraine can also cause facial pressure and a runny nose, which is why it is mislabelled so often. Repeated facial headaches without infection are usually migraine.
This article is general information, not medical advice. It cannot diagnose your pain. If your symptoms are new, worsening, or worrying you, speak with your family doctor or contact us for an assessment.
Talk to us about headaches that keep coming back
A headache that has not responded to the usual measures deserves a proper assessment rather than another round of tablets. Our physicians in North Toronto assess chronic headache and migraine, and treat the neck, nerve and jaw sources behind them.
Most services are covered by OHIP with a physician referral, and you can also refer yourself directly. Your family doctor can send a physician referral instead.
