Sinus pressure is a common discomfort caused by inflammation or congestion within the hollow, air-filled cavities in the skull. While most people experience this pressure across the face, the sensation can sometimes be perceived in distant areas. Pressure felt in the back of the head is rarely a direct symptom of typical sinus inflammation. However, an active sinus issue can indirectly trigger secondary headaches that manifest as pain or pressure in the occipital region.
Understanding Typical Sinus Pain Locations
The paranasal sinuses are four paired cavities named for their location in the facial bones: frontal, maxillary, ethmoid, and sphenoid sinuses. Inflammation typically causes pain corresponding directly to their position. Maxillary sinusitis, the most common form, often causes aching pressure in the cheekbones and upper teeth. Frontal sinusitis results in pain across the forehead, just above the eyes.
Ethmoid sinuses, located between the eyes and the bridge of the nose, usually cause pressure in that central facial area. The deepest are the sphenoid sinuses, situated near the center of the skull, behind the eyes. While sphenoid inflammation is less common, the pain can be referred to the top of the head or deep behind the eyes. Direct sphenoid pain is sometimes vaguely described toward the back of the head, but this is infrequent compared to common facial symptoms.
The Indirect Connection: Sinus Issues Triggering Secondary Headaches
The primary way sinus issues relate to pressure in the back of the head is by triggering secondary headaches. Severe or prolonged inflammation and congestion create generalized stress and discomfort across the head and neck. This constant facial pressure acts as a trigger for other headache types, primarily tension headaches or cervicogenic headaches.
Tension headaches involve a sensation of tightness or band-like pressure that often wraps around the head, frequently involving the occipital region. This neurological connection is due to referred pain, where nerves carrying pain signals from the face and sinuses share pathways with nerves that innervate the neck muscles and joints.
When the trigeminal nerve system is activated by sinus inflammation, the brain may misinterpret the sensation as originating from the neck or base of the skull. Furthermore, the discomfort of an illness, combined with constant coughing or nose-blowing, can cause unconscious tensing of the neck and shoulder muscles. This muscle strain results in a cervicogenic headache, which originates from the cervical spine and radiates into the back of the head. In these cases, the sinus infection is the initial trigger, but the resulting pain is a consequence of muscle tension and nerve referral.
Common Non-Sinus Causes of Back-of-Head Pressure
If pressure is localized primarily in the back of the head, it is often due to a cause unrelated to the sinuses. Tension headaches are the most common cause of this posterior pain, presenting as a dull, aching pressure described as a tight feeling around the head. These headaches are frequently triggered by stress, anxiety, or fatigue.
Neck muscle strain is another significant contributor, leading to cervicogenic headaches. Poor posture, such as habitually tilting the head forward while using a phone or computer, creates chronic strain on the muscles at the base of the skull. This results in pain that starts in the neck and spreads upward to the back of the head. Conditions like occipital neuralgia, where nerves running from the neck to the scalp are irritated, can also cause sharp, shooting, or burning pain.
Seeking Professional Diagnosis and Care
Accurate diagnosis is important because pressure in the back of the head can signal a range of conditions, both minor and serious. If back-of-head pain is persistent, severe, or accompanied by specific symptoms, a medical evaluation is warranted.
Watch for warning signs such as a sudden, explosive headache described as the “worst ever,” a stiff neck, high fever, or confusion. Neurological symptoms, including sudden vision changes, seizures, slurred speech, or weakness in the limbs, also necessitate immediate medical attention.
A healthcare provider, often an Otolaryngologist (ENT) or a neurologist, can differentiate between sinus-related issues and primary headaches. Diagnosis typically involves a physical and neurological examination. Sometimes imaging studies like a CT scan or MRI are used to visualize the sinuses and the structures of the brain and neck.