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Headache locations

What the pain location tells you about your headache

Dr. Michael Chen, MD - Board-Certified Neurologist
Reviewed by
Dr. Michael Chen, MD
Board-Certified Neurologist
10 min read

Key takeaways

  • Headache location provides important clues about headache type, but must be considered alongside other symptoms like pain quality, duration, and associated features.
  • Tension headaches typically cause bilateral pain (both sides) affecting the forehead, temples, and back of head like a tight band.
  • Migraines often (but not always) affect one side of the head, commonly around the temple or behind the eye, and may switch sides between attacks.
  • Pain in specific locations—like around the eye (cluster headaches), over the sinuses (sinus headaches), or at the base of skull (cervicogenic headaches)—can suggest particular headache types.
  • Always seek immediate medical attention for sudden, severe headache ('thunderclap headache'), headache with neurological symptoms, or pain that's different from your usual pattern.

Where your headache hurts can tell you a lot about what’s causing it. A throbbing pain behind one eye feels very different from a tight band around your forehead, and these differences aren’t random—they often point to distinct headache types with different underlying mechanisms and treatment approaches.

Understanding headache locations is like having a map to your pain. While location alone can’t diagnose a headache (other factors like pain quality, duration, and accompanying symptoms matter too), it provides valuable clues that can help you communicate with healthcare providers and better understand your own experience. Research shows that certain headache types have characteristic location patterns that aid in accurate diagnosis [1].


Quick reference: Headache locations at a glance

LocationMost Likely TypesKey Features
ForeheadTension, sinus, eye strainPressing, bilateral, may worsen throughout day
TemplesTension, migraine, TMJThrobbing or pressing, may be one-sided
Behind eyesMigraine, cluster, eye strainThrobbing, light sensitivity, may be severe
Top of headTension, compression, stabbingPressing or brief jabs, posture-related
Behind earOccipital neuralgia, TMJSharp/shooting or aching, jaw involvement
Base of skullTension, cervicogenicNeck-related, posture-triggered
One-sidedMigraine, cluster, cervicogenicMay switch sides (migraine) or stay fixed

Map your headache patterns with our location tracker

Knowing where your headaches typically strike—and whether that location changes—can reveal important patterns. Our headache location tracker helps you record exactly where you feel pain, how it spreads, and whether the location varies between episodes. This information is invaluable for identifying your headache type and discussing your symptoms with a healthcare provider. Of course, while tracking helps you understand your patterns, persistent or severe headaches deserve professional evaluation.


Does headache location matter for diagnosis?

Yes—but with an important caveat. Location is one piece of the diagnostic puzzle, not the whole picture. The International Headache Society classification uses location as one of several criteria for diagnosing headache types [2], but pain quality, duration, triggers, and accompanying symptoms are equally important.

For example, a headache behind your eye could be a migraine, a cluster headache, or even referred pain from tension in your neck. What distinguishes these isn’t just location but the constellation of other features: Is it throbbing or stabbing? Does it come with nausea or eye watering? Does it last hours or minutes?

That said, understanding location patterns can help you:


What does it mean when my headache is in the front of my head?

Frontal headaches—pain across the forehead—are among the most common headache locations. Several conditions can cause frontal head pain:

Tension-type headache

The most common cause of frontal headache is tension-type headache. The pain typically:

Tension headaches affecting the forehead are often related to muscle tension in the scalp, face, and neck, frequently triggered by stress, poor posture, or eye strain [3].

Sinus headache

True sinus headaches cause pain and pressure over the affected sinuses—particularly the frontal sinuses above the eyebrows. Key features include:

Important note: Studies show that up to 88% of self-diagnosed “sinus headaches” are actually migraines [4]. If you don’t have signs of infection but have recurrent frontal headaches with nausea or light sensitivity, you may be experiencing migraines.

Eye strain

Extended screen time or uncorrected vision problems can cause frontal headaches centered around the forehead and behind the eyes. These headaches typically worsen throughout the day and improve with rest.


What causes headaches at the temples?

Temple headaches—pain at the sides of the head—have several possible causes:

Tension-type headache

Tension headaches commonly affect the temples along with the forehead and back of head. The bilateral, pressing quality is characteristic.

Migraine

Migraines frequently involve temple pain, often on one side (though they can be bilateral). Migraine temple pain is typically:

TMJ disorder

The temporomandibular joint sits directly at your temple, and dysfunction in this joint commonly causes temple headaches. Clues that suggest TMJ involvement include:

Temporal arteritis (giant cell arteritis)

In adults over 50, new temple headaches should raise consideration of temporal arteritis—inflammation of arteries in the temple area. This is a medical emergency because it can lead to vision loss. Symptoms include:

If you’re over 50 with new, persistent temple headaches, see a doctor promptly.


What does a headache behind the eyes mean?

Pain behind one or both eyes is a common and often distressing headache location. Causes include:

Migraine

Migraines frequently cause pain behind or around the eye. The pain is typically:

Cluster headache

Cluster headaches cause severe, stabbing pain centered around or behind one eye. Distinctive features include:

Eye strain and vision problems

Overuse of the eyes—particularly from screens—and uncorrected vision problems can cause aching pain behind the eyes that worsens with visual tasks.

Sinus infection

The ethmoid and sphenoid sinuses sit behind the eyes, and infection in these sinuses can cause deep pain behind the eyes, typically with nasal symptoms and fever.


What causes headaches at the back of the head?

Pain at the back of the head (occipital region) has several common causes:

Tension-type headache

Tension headaches often affect the back of the head along with other areas, creating that characteristic “band around the head” feeling. Muscle tension in the neck and shoulders frequently contributes.

Cervicogenic headache

These headaches originate from problems in the neck (cervical spine) but cause pain that radiates to the back of the head. Features include:

Cervicogenic headaches are common in people with neck injuries, arthritis, or poor posture [5].

👉 Learn more: Headache at base of skull: Causes and treatment

Occipital neuralgia

This condition involves irritation of the occipital nerves that run from the upper neck to the back of the scalp. The pain is typically:

👉 Learn more: Headache behind ear: What’s causing your pain

Hypertension headache

Severely elevated blood pressure can cause headaches at the back of the head. These headaches are often present upon waking and are a sign that blood pressure needs urgent attention.


What causes headaches at the top of the head?

Pain at the very top of the head—the crown or vertex—is less common but can feel particularly unusual. Causes include:

Tension-type headache

The most common cause of vertex pain. Tension in the epicranial muscles (at the top of the head) from stress, clenching, or sustained postures can create localized pressure at the crown.

External compression headache

Often overlooked: tight hats, headbands, helmets, ponytails, or headphones can compress the scalp and cause pain exactly where the pressure occurs. Relief comes quickly once you remove the culprit.

Primary stabbing headache

Brief, intense “ice pick” jabs that can strike anywhere on the head, including the top. These last only seconds but can be alarming. They’re usually benign.

👉 Learn more: Headache top of head: Causes and relief


What about one-sided headaches?

Headaches that consistently affect one side of the head have specific implications:

Migraine

Migraines are classically one-sided (unilateral), though about 40% of migraine attacks affect both sides [6]. The pain may switch sides between attacks. One-sided throbbing pain with nausea or light sensitivity strongly suggests migraine.

Cluster headache

Always one-sided, always affecting the same side during a cluster period. The pain centers around the eye and temple.

Hemicrania continua

A rare but important condition causing continuous one-sided headache that never switches sides. It responds specifically to the medication indomethacin.

Cervicogenic headache

Often one-sided, originating from neck problems and referring pain to one side of the head.


When should I be concerned about headache location?

While most headaches—regardless of location—are benign, certain features warrant immediate medical attention:

Seek emergency care for:

See a doctor soon for:


Using location to understand your headaches

Paying attention to where your headache strikes—and whether that pattern is consistent—adds valuable information to your headache story. Combined with other details like pain quality, duration, triggers, and accompanying symptoms, location helps paint a complete picture.

Keep a headache diary noting location, intensity, quality, duration, and associated symptoms. Over time, you’ll recognize your patterns and be better equipped to discuss your experience with healthcare providers.

Remember that headache location is a clue, not a diagnosis. If your headaches are frequent, severe, or affecting your quality of life, bring your observations to a healthcare provider. With accurate information about your headache patterns, they can help you find effective relief.

Your pain has a pattern—and understanding that pattern is the first step toward taking control.

Track your headaches with MigraineCat

Log symptoms, identify triggers, and share detailed reports with your doctor. Start understanding your headache patterns today.

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References
  1. 1. Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. doi:10.1177/0333102417738202
  2. 2. Olesen J. The International Classification of Headache Disorders. Headache. 2008;48(5):691-693. doi:10.1111/j.1526-4610.2008.01121.x
  3. 3. Jensen RH. Tension-type headache—the normal and most prevalent headache. Headache. 2018;58(2):339-345. doi:10.1111/head.13067
  4. 4. Schreiber CP, et al. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed 'sinus' headache. Archives of Internal Medicine. 2004;164(16):1769-1772. doi:10.1001/archinte.164.16.1769
  5. 5. Bogduk N, Govind J. Cervicogenic headache: An assessment of the evidence on clinical diagnosis, invasive tests, and treatment. The Lancet Neurology. 2009;8(10):959-968. doi:10.1016/S1474-4422(09)70209-1
  6. 6. Kelman L. Pain characteristics of the acute migraine attack. Headache. 2006;46(6):942-953. doi:10.1111/j.1526-4610.2006.00443.x

This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.

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