Headache behind ears: Causes, symptoms, diagnosis, treatment, and prevention

Headaches are a common occurrence and occur to everyone at least once in their lives. There are more than 300 types of headaches currently known, and some occur in various regions of the head.

One of these locations is behind the ears, and there are a number of  reasons for it to occur there. Headaches behind the ear may at least provide a clue to the origins of a headache.

What causes a headache behind the ears?

While it may not always be possible to identify why a headache has occurred, pain behind the ear may be enough to narrow down the potential causes. These may include:

• Occipital neuralgia: Caused by an injury or pinched nerves in the neck, which can happen if you keep your neck bent for long durations. It may also be due to arthritis in the neck and shoulders. This condition can cause pain and throbbing in the neck area, in the back, or even on one side of the head. Occasionally, some people feel pain in the forehead or behind the eyes. Pain typically travels upwards, starting from the neck.
• Mastoiditis: The mastoid is a bone found behind the ear, and when it becomes inflamed or infected, it leads to a condition called mastoiditis. It can occur as a result of an untreated infection of the middle ear and is commonly seen in children, but it can affect anybody. Typical signs of this condition include redness, swelling, and ear discharge. Headaches, fever, and loss of hearing can also be seen.
• Temporomandibular joint (TMJ) disorder: The TMJ helps your jaw open and close. If this joint is out of alignment, injured, or damaged by arthritis, the smoothness of this jaw action is affected. A grinding or crackle sensation can often be felt when your mouth moves with TMJ. This condition makes it difficult to chew, with clicking or popping sounds occurring when opening and closing your jaw. Pain is a common symptom.
• Dental problems: Having issues with your mouth or teeth can result in pain traveling from inside the mouth to your head, leading to headaches. This is called referred pain. Signs of dental problems often include bad breath, gum tenderness, or difficulty chewing.

What are other symptoms of a headache behind the ears?

Other symptoms occurring with behind the ear headache often depend on the underlying cause of the condition. For example, occipital neuralgia may cause pain starting at the neck then travel up toward the back of the head. Infection leading to headaches often present with additional symptoms of fever or fatigue. But symptoms of a headache generally have a few symptoms that can be easily recognized. They are as follows:

• Pain on one or both sides of the head
• Photosensitivity (sensitivity to light)
• Aching, burning, or throbbing pain
• Pain behind the eyes
• Tender scalp
• Pain with neck movement

Diagnosing a headache behind the ears

When seeing your doctor for episodes of a headache behind the ears they will ask you to tell them a brief history of when you started to experience these symptoms. This will include obtaining a full medical history of any previous disorder to help with making an accurate diagnosis.

Next will come the physical exam, which involves visual and physical infection of the area of pain. By firmly pressing on the base of the skull, your doctor will be able to assess if the area is tender. Conditions such as occipital neuralgia is sensitive to touch.

If your doctors feel it is necessary, a detailed imaging scan can be done. This often comes in the form of magnetic resonance imaging (MRI), as it is sensitive enough to view any pathology within the brain.

Looking for the signs of infection will also help in ruling out condition like mastoiditis

Treating a headache behind the ears

When first visiting your doctor, they will most likely give you some immediate forms of therapy to help ease your headache symptoms. This may come in the form of dimming the lights if they are causing you to become sensitive to them or even the direct placement of a pack of ice on the area of pain. The underlying cause of your specific headache behind the ear will guide which therapy is used. Some examples include:

• Occipital neuralgia: Can be relieved anti-inflammatory and pain medications, with local nerve blockers and muscle relaxant providing additional benefit. Severe cases of neck pain may require the use of corticosteroids to be injected directly into the problem area.
• Mastoiditis: Considering this is due to a bacterial infection the use of antibiotics is the treatment of choice.
• TMJ: Several treatments for this condition exist. These may include the use of pain relievers, oral splints, or physical therapy

Preventing a headache behind the ears

While it may be difficult to anticipate and avoid getting a headache, there are some things you can do to cut down your risk. The following are some tips to help reduce the occurrence of a headache behind the ears:

• Limit handheld device use: Our necks are often at a downward slant when using our phones or other small screened devices.
• Be mindful of your posture: Prolonged slouching or keeping your head and neck in the same position can lead to pinched nerves.
• Eat on schedule: Skipping meals can lead to headaches.
• Take a break: Taking the time to get up and take a short walk when working at a desk all day can help prevent stiffness in your neck and shoulders.
• Rest up: Getting a good night’s sleep is a great way to prevent stress and fatigue; two risk factors for headache development.

Related: Types of headaches and causes, symptoms, and prevention chart