Headaches can happen at any time, sometimes for no obvious reason. It’s a symptom with many different causes and knowing what may have caused it can be useful in knowing how best to treat the pain.
It’s also important to know when you should see a doctor.
Most headaches are nothing to worry about and improve with treatment or medication from a pharmacist. But a headache on the top of your head — or in another location — can occasionally be a sign of something more serious.
Common causes of pain on the top of your head
If you feel a dull pain on the top of your head, chances are this is a tension headache, which is the most common type of headache.
Sometimes described as an ‘everyday’ headache, a tension headache shouldn’t stop you doing normal tasks, as usually any pain is manageable. It may last for anything from to 2 hours to 2 days.
A tension headache has many causes, but the most common include stress (emotional or physical), not getting enough sleep, tiredness, anxiety and depression.
Stress is strongly linked to tension headaches. This is because the pain or pressure you feel on the top of your head happens as a result of your scalp, neck or shoulder muscles tightening in response to stress. This is why your head and neck muscles can feel tense when you have this type of headache.
You may also get a tension headache from sitting too long at a computer, or from doing work that requires you to sit in the same position for over a long period of time, particularly if you have poor posture. Any activity like this causes the muscles in your upper body to seize up, and can contribute to a tension headache.
However, tension headaches can also cause pain in other locations on your head.
You shouldn’t need to see a doctor for a tension headache unless the pain prevents you from doing normal tasks, or if you’re getting headaches 2 times a week or more. Instead, you should:
- stay hydrated
- try to minimise stress
- relax the muscles in your upper body by taking a bath or doing stretches or exercise
Painkillers may also help, but speak to a pharmacist or doctor for further guidance on these medications, and how to get and use them.
If you have a throbbing pain in the top of your head it may be a migraine.
Migraines are typically more painful than a tension headache so you’re more likely to need painkillers. Speak to a pharmacist or a doctor for advice on how to get and take them.
Migraines have multiple triggers, including:
- emotional stress
- hormonal changes
- feeling hungry
- smoking too much
- certain foods
- bright or flashing lights
- certain smells, such as paint fumes or perfume
Your head pain may also be accompanied by other symptoms, such as sweating or being sick.
A migraine can cause pain in other places on your head, not just on the top. But the reason you have a migraine may be due to changes in brain cell activity that may, in part, be due to your genetic make-up. These changes may alter levels of the brain chemical serotonin or hormones like oestrogen.
When your hormone or chemical levels fall, this causes your blood vessels to contract and narrow. It’s this tightening of the blood vessels which may lead to a build-up of pressure on the top of your head (or elsewhere), and create the throbbing pain of a migraine.
Women are more likely to get migraines than men, and this may be because a woman’s hormone levels rise and fall throughout life, for example, during her period.
See a doctor if the pain or any other symptoms are severe, or if you have migraine symptoms 2 or more times a week.
To help ease any symptoms, lying down in a dark room may help, especially if you think bright light was a trigger. You may feel hot or flushed with a migraine, so an ice pack or cold compress can help cool the top of your head.
You should also look to identify what may have triggered your migraine so you can avoid possible triggers in future. There’s a range of medication a doctor may prescribe for a migraine, including anti-sickness medication. You could even try acupuncture.
Less common causes of pain on the top of your head
Tension headaches and migraines are both examples of primary headaches, which means they’re not caused by an injury or a medical condition. However, a headache on the top of your head may, occasionally, be caused by this.
If you’ve injured your head and you have a headache — either on the top of your head or elsewhere on your head — you should seek medical help immediately.
This is because if you’ve injured your head, for example if an object has fallen on it, you can injure your brain (traumatic brain injury, or TBI). Such an injury can lead to recurring headaches (post-traumatic headaches). Any of these headaches — around 85% — are tension-type headaches, but a migraine is also possible.
Even mild head injuries can result in headaches.
As with any tension headache you may feel pressure, tightness and a dull ache on the top or on other parts of your head.
High blood pressure
Though more rare, high blood pressure (hypertension) can cause a headache. This is called a hypertension headache and is more likely if your blood pressure is very high.
High blood pressure can cause swelling around the brain, but as the brain can’t expand, this swelling places more pressure on the brain and skull, sometimes resulting in a headache.
If you have a headache caused by high blood pressure you may feel a constant pain on the top of your head, though this type of headache may also cause pain in other parts of your head.
If you have a headache that is severe, doesn’t go away or keeps returning, always see a doctor. You should also see a doctor if you know you have high blood pressure and you get headaches.
A doctor will help you to keep your blood pressure levels under control with medication, and you may need to make changes to your lifestyle, like reducing alcohol and salt intake, and following a balanced diet.
In rare cases, a headache that comes on suddenly and is especially painful can be a sign of an aneurysm. This occurs when a blood vessel in the brain is weakened, causing it to swell or bulge. There’s also a risk this weakened part of the blood vessel will burst.
A severe headache can be 1 of the first symptoms of an aneurysm. One that hasn’t burst may occasionally cause headaches, but isn’t likely to lead to chronic headaches.
There are many causes of an aneurysm, including:
- high blood pressure
- age (your risk increases as you get older)
- injury to the brain
- having a close relative who’s had an aneurysm
You should get medical help immediately if you have a headache and you:
- have pain around or above an eye
- are sensitive to light
- are seeing double or your vision is blurred
- have numbness on 1 side of your face
- find it hard to speak or concentrate
- feel or are sick
- have a fit (seizure)
- if you have a headache on the top of your head the most likely causes are a tension headache and migraine
- tension headaches have many causes, including stress, tiredness, anxiety or depression
- migraines have many causes, including hormonal changes, bright lights, and certain foods and smells
- a headache in this location can also be caused by an underlying injury, illness or medical condition
- if your headache is severe, constant or comes on suddenly, or you have 2 or more headaches a week, you should seek medical help