Pain at the top of the head can be caused by a variety of different types of headaches including tension headache and migraine.

Headaches are never fun, and each type of headache can produce its own unique symptoms. Headaches that occur on the top of the head may cause the sensation of having a heavy weight placed on the crown of your head or a tight band across the head.

Identifying exactly what type of headache you’re experiencing is crucial to finding the right treatment and getting relief.

Several different conditions can cause headaches on top of your head. These can include different types of headaches, nerve issues, and more rare causes.

There are a number of different forms of headache that can cause pain on top of the head.

Tension-type headaches

Tension headaches cause constant pressure or aching around the head, which may feel like a tight band has been placed around the head.

You may also feel pain in your neck and near the back of your head or temples. The pain is dull and doesn’t throb, and it’s often much less severe than that of a migraine. Although these headaches are uncomfortable, many people with tension headaches are able to resume their typical activities.

Episodes of tension-type headaches can last from about 30 minutes to 1 week.

Migraine

Migraine is a neurological condition that causes severe and debilitating headaches. It may cause headache pain on the top of the head, though it may also appear on or travel to one side of the head or the back of the neck.

Migraine can cause severe throbbing pain, along with symptoms that can also include:

  • light sensitivity
  • sound sensitivity
  • nausea
  • vomiting
  • auras, or visual disturbances

Migraine can be episodic or chronic, depending on how often the headache attacks occur.

Cold-stimulus headaches

Cold-stimulus headaches — commonly known as “brain freezes” — come on quickly and are felt near the top of the head. They will be severe, and typically only last a few seconds. They may occur after you eat or drink something cold, such as ice water or ice cream.

Chronic headaches

Chronic headaches occur when a person experiences headaches for 15 or more days of the month. This is an umbrella term that doctors use to refer to multiple conditions.

Chronic headaches can come in many different forms. These can include:

  • migraine, which can be chronic or episodic (occurring less frequently)
  • tension headache
  • cluster headaches, which are severe headaches that occur in clusters followed by headache-free periods
  • new daily persistent headache, a rare headache condition that is not caused by another disorder
  • hemicrania continua, a severe headache that occurs on one side of the head

Occipital neuralgia occurs when the nerves that move from the spine to the scalp are damaged, irritated, or compressed. They can cause pain at the back of the head, or a tight, band-like feeling around the top of the head.

Other symptoms can include:

  • jolts of pain that feel like electric shocks
  • dull aching
  • symptoms that increase upon movement

While rare, these causes are medical emergencies. If you experience any of the below conditions, call 911 or your local emergency services.

This is a condition that can cause vascular spasms in the brain, triggering a severe “thunderclap” headache near the top of the head.

This condition may cause strokes or bleeding in the brain. Other symptoms may include:

  • severe weakness
  • seizures
  • blurred vision

Hypertension headaches occur when severe high blood pressure causes pressure to build in the cranium. This is also known as an hypertensive crisis.

This may cause a severe headache along with other symptoms like:

  • nosebleeds
  • shortness of breath
  • severe anxiety

Pain on top of the head can have numerous potential causes, and won’t always involve muscles.

In some cases, like tension headaches, muscles play play a role in pain in the head.

Excessive flexing of the neck when working at a computer or screen can cause tension headache. The shoulders may attempt to make up for a stooped posture and tighten.

Headache pain can have numerous causes, and the way pain is treated can vary. The type of headache will determine the treatment.

Some forms of headache may be able to be managed at home. At home treatments may include:

  • going to a dark room to rest
  • drinking water and remaining hydrated
  • using a cool cloth on the head
  • practicing relaxation techniques

Some people may find medications are helpful for managing tension headaches. These may include:

  • aspirin (Bayer Aspirin)
  • ibuprofen (Advil)
  • acetaminophen (Tylenol)

However, you should consult with a healthcare professional if you feel you need these medications more than 3 days a week.

If your headaches are frequent or more severe, a doctor may prescribe medications or develop a customized treatment plan. Treatment can vary by underlying cause:

  • Tension headaches: These headaches may be treated with over the counter medications, stress management techniques, massage and acupuncture.
  • Migraine: Treatment may involve both preventative and immediate-relief medications. Medications may include erenumab (Aimovig), lasmiditan (Reyvow), ubrogepant (Ubrelvy), Botulinum toxin A, as well as medications originally intended for depression, high blood pressure and epilepsy.
  • Occipital neuralgia: This condition may be treated with rest and massage. If the pain is severe, antidepressants may be used. Steroid injections and local nerve blocks are also an option.
  • RCVS: This condition may clear up without treatment, but calcium channel blockers may help reduce headaches caused by the condition (though they do not reduce the risk of stroke).
  • Hypertension headaches: These headaches typically occur in a dangerous state called hypertensive crisis, require immediate emergency treatment to reduce risk of brain bleeding, stroke, or other serious conditions. Medications will be administered to bring blood pressure down as quickly as possible. This is typically done through an IV.

If a doctor prescribes treatment that isn’t working for you, or you experience side effects from the medication, let them know.

Not every headache requires medical attention from a healthcare professional. But according to the National Institute of Neurological Disorders and Stroke, there are some circumstances in which further medical investigation is warranted.

This may include:

  • headache accompanied by fever
  • sudden, severe headache
  • sudden headache with a stiff neck
  • headache accompanied by convulsions
  • headache accompanied by confusion
  • headache accompanied by loss of consciousness
  • headache with pain in the ear or eye
  • headache following a knock to the head
  • persistent headaches in someone who previously was headache free
  • recurring headaches in children

If you don’t already have a provider, our Healinggeeks FindCare tool can help you connect to physicians in your area.