A headache or pain behind the ear can have many causes, including nerve damage, bone infection, and dental problems. Medical treatment can help relieve these headaches. A headache behind the ear refers to any pain that originates in that specific area of the head. Although headaches are very common, those that occur exclusively behind the ear are quite unusual. This article explores the signs and symptoms of headaches behind the ear and details the causes. It also discusses how they can be treated to relieve pain and associated symptoms.
There are several possible causes of a headache behind the ear. These include in particular the following:
Occipital neuralgia.
One of the most common causes of a headache behind the ear is a condition called occipital neuralgia. Occipital neuralgia occurs when the occipital nerves, or the nerves that run from the top of the spinal cord up to the scalp, are injured or inflamed. People often confuse sharp pain behind the ear with a migraine or other types of headaches because the symptoms can be similar. People who suffer from occipital neuralgia describe the chronic pain as piercing and throbbing. They also describe it as similar to the sensation of receiving an electric shock in the following places:
the top of the neck
the back of the head
behind the ears
Occipital neuralgia results from pressure or irritation of the occipital nerves. It usually only appears on one side of the head. In some cases, the pressure or irritation may be due to inflammation, over-tightened muscles, or injury. Often, doctors cannot find a cause for occipital neuralgia.
Mastoiditis
Mastoiditis is an infection of the mastoid bone, which is the bone directly behind the ear. This infection is much more common in children than in adults and usually responds to treatment without complications. Mastoiditis causes a headache behind the ear along with fever, discharge from the ear, fatigue, and hearing loss in the affected ear.
ATM
The temporomandibular joints (TMJ) are the ball and socket joints of the jaw. These joints can become inflamed and painful. While most people with TMJ inflammation experience pain in the jaw and behind the ear, others may simply experience a headache behind the ear.
TMJ can be caused by:
the stress
teeth grinding
arthritis
a wound
jaw alignment
Symptoms
Symptoms of headaches behind the ear can vary depending on the causes. Occipital neuralgia can cause severe pain in the back of the head and/or upper neck. Often it can start in the neck and work its way up to the back of the head. The episodic pain is like an electric shock to the back of the head and/or neck.
Signs of an infection, such as fever or fatigue, often accompany mastoiditis. TMJ sufferers may experience jaw tension and pain in addition to a headache behind the ear.
Additional symptoms that people who suffer from headaches behind the ear may experience include:
pain on one or both sides of the head
light sensitivity
aching, burning, throbbing pain
pain behind eyes
scalp sensitivity
pain when moving the neck
Diagnostic
The main causes of headache behind the ear often overlap. It is crucial to get a correct diagnosis so that the condition can be treated appropriately. To make a diagnosis, a doctor will ask about the person’s medical history. Information on any recent head, neck or spinal injuries should be included. After asking questions, the doctor will likely perform a physical exam. For this, the doctor will press firmly on the back of the head and the base of the skull to try to reproduce the pain on the touch. This examination helps to check for the presence of occipital neuralgia, as this condition is sensitive to touch in most cases. Some additional diagnostic steps may include a prick to numb the nerve. If the person is relieved, it is likely that occipital neuralgia is the cause of the pain.
In more atypical cases, the doctor may order an MRI or blood test to confirm or rule out other causes of the pain. If occipital neuralgia is ruled out as a possible cause of the pain at the initial visit, the doctor will likely look for signs of mastoiditis, including fever and discharge from the ear. For further diagnosis, the doctor may examine the jawbone or recommend a visit to the dentist to check the TMJ.
Home treatments
Treating the pain is the primary method of coping with a headache behind the ear, unless a root cause can be determined. There are home treatment options that people can try before or in addition to a doctor’s care.
Here are some at-home approaches:
rest in a quiet room
taking over-the-counter anti-inflammatories
neck muscle massage
apply heat to the back of the neck. Heat packs are available in pharmacies
reduce stress
stop teeth grinding
As with any treatment option, a doctor should be consulted before adding medication.
Treatment of headaches behind the ear
When a person is followed by a doctor, they are provided with a treatment plan for headache behind the ear that includes pain management and treatment of the underlying causes of the pain.
Depending on the exact cause of the headache behind the ear, a doctor may prescribe medications, including:
prescription muscle relaxants
steroid injections
physical therapy
antidepressants
anticonvulsants
antibiotics if mastoiditis is suspected
a night protection device for the ATM.
Operations may include:
Microvascular decompression: This procedure involves the doctor finding and repositioning the blood vessels that are compressing the nerves.
Occipital nerve stimulation: A neurostimulator delivers multiple electrical impulses to the occipital nerves. In this case, the electrical impulses can help block the pain messages transmitted to the brain. Whatever treatments are decided upon, it is important to tell a doctor whether or not they are effective. In some cases, persistent pain may indicate that it is the result of another condition, which needs to be treated differently.
Outlook
In many cases, people experience pain relief when they rest and take prescribed or indicated medications. In most cases, sufferers of a headache behind the ear should experience complete or nearly complete relief of their symptoms with proper diagnosis and treatment.
