A tender spot on the head, painful when touched, is a distinct symptom that can be alarming, especially when the cause is not immediately obvious. This localized sensitivity arises from irritation or inflammation in the structures directly beneath the skin. The feeling is often described as a sharp ache or hypersensitivity that makes simple actions like lying on a pillow or combing hair uncomfortable. Understanding the specific origin of this tenderness is the first step toward finding relief, as causes range from minor surface irritation to issues involving underlying nerves and muscles.
Superficial Causes: Skin Conditions and Minor Trauma
The most common reasons for localized head tenderness originate in the scalp or hair follicles. A recent knock to the head, even a mild one, can leave a small bruise or contusion that is painful only when light pressure is applied. Similarly, friction from tight headwear, such as helmets or headbands, can irritate the skin and the delicate nerves beneath the surface.
Inflammatory skin conditions are another frequent source of tenderness in a single spot. Folliculitis is an inflammation or infection of the hair follicles that creates small, red, pus-filled bumps which are sore to the touch. Seborrheic dermatitis, or severe dandruff, can also cause patches of inflamed, irritated skin that become hypersensitive, often including visible signs like scaling or redness.
Muscular Tension and Referred Pain
A tender spot on the head may not actually be caused by a problem in that exact location, but rather by referred pain originating from tense muscles elsewhere. This phenomenon occurs when muscle knots, known as myofascial trigger points, develop in the neck and shoulder area. These knots can send pain signals that the brain interprets as coming from a distant site on the scalp.
The suboccipital muscles, located at the base of the skull, are particularly prone to developing these trigger points due to poor posture or chronic stress. When these muscles become tight, they can refer pain upward, creating a tender spot often felt at the back of the head or sometimes behind the eyes.
This type of tenderness is commonly associated with tension headaches, where the muscle tension is the primary cause of the localized pain. The pain is usually described as a dull ache or pressure, but the spot itself is acutely sensitive when pressed.
Neuralgia: Pain Originating from Irritated Nerves
A more intense and localized form of tenderness often points toward a condition called neuralgia, which involves irritation or inflammation of a specific nerve pathway. Occipital neuralgia is the most common form affecting the head, involving the occipital nerves that run from the upper spine, through the muscles at the back of the head, and into the scalp. When these nerves are compressed or injured, they can produce severe symptoms.
The hallmark of occipital neuralgia is sharp, shooting, or electric-shock-like pain that typically starts at the base of the head and spreads over the scalp. This nerve irritation causes extreme sensitivity to touch, a condition called allodynia, where even the lightest sensation, like brushing hair or resting on a pillow, is perceived as painful. The tenderness is often localized to the areas where the greater and lesser occipital nerves travel.
Unlike muscular pain, which is often a dull ache, the pain from neuralgia is typically intermittent, intense, and described as an electrical jolt.
Identifying Red Flags and Seeking Medical Help
While most causes of a tender spot on the head are benign, certain accompanying symptoms suggest a more serious underlying issue that requires immediate medical attention. Red flag signs include a sudden, severe headache described as the “worst headache of your life,” or tenderness that develops rapidly after a significant head injury. Other concerning symptoms are a fever, persistent vomiting, neck stiffness that limits movement, or neurological changes such as weakness, confusion, or vision loss.
If the localized tenderness is persistent, worsens over time, or is accompanied by any of these red flags, it is prudent to consult a healthcare professional. A physical examination, including a neurological assessment and palpation of the tender area, is the first step in diagnosis. Depending on the suspected cause, a doctor may order imaging tests, such as X-rays or an MRI, to check for nerve compression or other structural issues. It is important to remember that this information is for educational purposes and is not a substitute for personalized medical advice.