Headaches are pain in the head, scalp, or upper neck that range from occasional tension headaches to migraine, cluster headache, cervicogenic headache, and occipital neuralgia. Nearly everyone has one at some point, and Cleveland Clinic reports that about 96% of people experience a headache at least once in their life. The board-certified pain specialists at California Pain Consultants in San Diego diagnose recurring and chronic head pain and offer treatments, including targeted nerve blocks, for headaches that have not responded to standard care.
Head pain is something almost everyone experiences at some point—but for many people, it becomes more than just an occasional inconvenience. It can interrupt your focus. It can make simple tasks feel overwhelming. It can affect your work, your relationships, and your ability to enjoy daily life. For some, it starts as a mild headache after a long day. For others, it comes on suddenly—intense, throbbing, or sharp—forcing you to pause everything. And for those living with chronic head pain, it can feel like a constant presence that never fully goes away. If you’re dealing with recurring or persistent head pain, you may find yourself asking what’s causing it and what can actually help.
Headaches have many patterns, from tension-type headache and migraine to cervicogenic pain and occipital neuralgia. Frequency, triggers, associated symptoms, and examination findings guide the treatment plan.
Understanding Head Pain: More Than Just a Headache
Head pain is a broad term that includes various types of headaches and related conditions. While many people use the word “headache” casually, medically, head pain can come from different sources and mechanisms.
Your head contains:
- A network of blood vessels
- Nerves that transmit pain signals
- Muscles in the scalp, neck, and face
- Sinuses and surrounding structures
Interestingly, the brain itself does not feel pain—but the surrounding tissues do. When these tissues become irritated, inflamed, or stressed, pain signals are sent to the brain. Head pain can be:
- Acute – occasional and short-lived
- Chronic – occurring frequently (more than 15 days a month)
- Episodic – comes and goes
- Progressive – worsens over time
Understanding what type of head pain you’re experiencing is the first step toward effective treatment.
How Head Pain Feels: Recognizing Different Patterns
Head pain can feel very different depending on its cause.
You may experience:
- Dull, aching pressure
- Throbbing or pulsating pain
- Sharp or stabbing sensations
- Tightness around the head
- Pain behind the eyes
- Sensitivity to light or sound
It may affect:
- One side of the head
- Both sides
- The forehead
- The back of the head
- The temples
Some headaches build gradually, while others come on suddenly and intensely.
Recognizing patterns—when the pain starts, how long it lasts, and what triggers it—can help guide diagnosis and treatment.
Common Types of Head Pain
Tension Headaches: The Most Common Type
Tension headaches are often described as a tight band around the head. Cleveland Clinic estimates that about 40% of people worldwide have tension-type headaches, compared with about 10% who have migraine. Symptoms include:
- Dull, aching pain
- Pressure on both sides of the head
- Tightness in the neck and shoulders
These headaches are often linked to stress, posture, and muscle tension.
Migraines: More Than Just a Headache
Migraines are a neurological condition and can be much more intense than typical headaches. Symptoms may include:
- Throbbing pain (often on one side)
- Nausea or vomiting
- Sensitivity to light and sound
- Visual disturbances (aura)
Migraines can last for hours or even days and significantly impact daily life. The National Institute of Neurological Disorders and Stroke notes that migraine affects women more often than men, while cluster headache is more common in men.
Cluster Headaches: Severe and Intense
Cluster headaches are less common but extremely painful. They are characterized by:
- Severe, burning pain around one eye
- Redness or tearing in the eye
- Nasal congestion
They often occur in cycles or “clusters” over weeks or months.
Sinus Headaches
Caused by sinus inflammation or infection. Symptoms include:
- Pressure in the forehead, cheeks, or around the eyes
- Pain that worsens when bending forward
- Nasal congestion
Cervicogenic Headaches
These headaches originate from the neck. They may include:
- Pain that starts in the neck and radiates to the head
- Limited neck movement
- Pain triggered by certain positions
Occipital Neuralgia
A nerve-related condition affecting the back of the head. Symptoms include:
- Sharp, shooting pain
- Pain at the base of the skull
- Sensitivity in the scalp
What Causes Head Pain?
Head pain can result from many different factors, including:
Muscle Tension and Stress
Emotional stress can cause muscles in the neck and scalp to tighten, leading to tension headaches.
Posture and Lifestyle
- Prolonged screen time
- Poor posture
- Lack of movement
Hormonal Changes
Especially common in migraines.
Sleep Issues
Too little or too much sleep can trigger headaches.
Dehydration and Diet
- Skipping meals
- Certain foods (like caffeine or processed foods)
- Alcohol
Underlying Medical Conditions
- Sinus infections
- Neck problems
- Nerve irritation
Diagnosing Head Pain: Finding the Root Cause
Medical History
Your provider will ask about:
- Frequency and duration of headaches
- Triggers and patterns
- Associated symptoms
Physical Examination
- Neurological evaluation
- Neck and muscle assessment
Imaging Studies
- MRI or CT scans if needed
- Used to rule out serious conditions
Conservative Treatments
Lifestyle Changes
- Improving sleep habits
- Staying hydrated
- Managing stress
Physical Therapy
Especially helpful for tension and cervicogenic headaches.
Medications
- Pain relievers
- Preventive medications for chronic headaches
Pain relievers are best used with a plan. Taking them too often can lead to daily rebound headaches, known as medication overuse headache, which is one reason frequent headaches deserve a structured evaluation.
Interventional Pain Management
Nerve Blocks
Target specific nerves to interrupt pain signals.
Trigger Point Injections
Relieve muscle tension in the head and neck. Trigger point injections may be helpful when tender knots in the neck and shoulder muscles reproduce your headache.
Occipital Nerve Blocks
Used for migraines and occipital neuralgia.
Sphenopalatine Ganglion Block
A sphenopalatine ganglion block targets a nerve cluster behind the nose and may be considered for selected patients with migraine or cluster headache.
Radiofrequency Ablation (RFA)
Provides longer-lasting relief by disrupting pain signals.
Neuromodulation: Advanced Relief for Chronic Head Pain
For patients with persistent headaches, neuromodulation may offer new options.
These therapies work by:
- Modifying how the brain processes pain signals
- Reducing the intensity and frequency of headaches
Patients often experience:
- Fewer headache days
- Reduced pain severity
- Improved quality of life
Preventing Head Pain: Everyday Strategies
- Maintain good posture
- Take breaks from screens
- Stay hydrated
- Manage stress
- Keep a consistent sleep schedule
The Emotional Impact of Head Pain
Chronic head pain can affect more than your body.
You may feel:
- Frustrated
- Exhausted
- Anxious about the next episode
Living with Head Pain: Practical Tips
- Keep a headache diary
- Identify triggers
- Practice relaxation techniques
- Stay consistent with treatment
Headache Warning Signs
Call 911 or seek emergency care for:
- A sudden thunderclap headache or the worst headache of your life
- Headache with facial droop, weakness, numbness, confusion, fainting, or speech difficulty
- Headache with fever, a stiff neck, seizure, or a new rash
- A severe headache after a head injury, during pregnancy, or with sudden vision loss
New, progressively worsening, or frequently recurring headaches should also be evaluated by a qualified clinician.
Understand the Pattern Behind Your Headaches
A detailed headache evaluation can clarify likely triggers and pain generators, then match treatment to the specific headache type and its effect on daily life.
When to See a Pain Specialist for Headaches
Occasional headaches that respond to rest, fluids, or an over-the-counter pain reliever usually do not need specialist care. Consider an evaluation when:
- You have headaches on several days each week, or one or more headaches every week
- You are taking pain relievers more than a few days a week to get through
- Headaches start in the neck, follow an injury, or worsen with certain neck positions
- Sharp, shooting pain at the base of the skull suggests occipital nerve involvement
- Preventive medications have not helped enough or caused side effects you could not tolerate
The warning signs listed above call for emergency care, not a scheduled visit.
Getting Headache Care in San Diego
At California Pain Consultants, your care team focuses on the pain generators that interventional treatment can address, such as irritated occipital nerves, tight neck and scalp muscles, and pain arising from the cervical spine. Your evaluation includes a detailed headache history, a neurological and neck examination, and a review of any prior imaging. Many patients find a neck pain evaluation is part of the picture. We coordinate with your neurologist or primary care physician so your plan works alongside the medications you already take.
We see patients at four clinics across San Diego County: Kearny Mesa, Rancho Bernardo, La Mesa, and Chula Vista. We accept most insurances. You can request your appointment online or call (858) 571-3630.
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Medical reference: National Institute of Neurological Disorders and Stroke: Headache. Related California Pain resources: Occipital nerve blocks · Radiofrequency ablation. This article is for general education and does not replace an individualized medical evaluation. Treatment recommendations depend on diagnosis, health history, current medications, and personal goals.
Frequently Asked Questions
When is a headache considered chronic?
A headache pattern is generally called chronic when headaches occur frequently, on more than 15 days a month, and the pattern persists over time. Chronic headaches can be tension-type, migraine, or related to medication overuse or neck problems. If you are having headaches more days than not, a structured evaluation can help identify the type and the best treatment.
Can neck problems cause headaches?
Yes, problems in the upper neck can cause cervicogenic headaches. Pain typically starts in the neck or base of the skull and spreads toward the forehead, temple, or around the eye, often on one side. Limited neck motion and pain with certain postures are common clues. Diagnostic nerve blocks can help confirm whether the neck is the source.
What is an occipital nerve block?
An occipital nerve block is an injection of local anesthetic, sometimes with a steroid, near the occipital nerves at the back of the head. It may reduce pain from occipital neuralgia and help some patients with migraine or cluster headache. The procedure takes only a few minutes in the office, and relief varies from person to person.
Are nerve blocks for headaches safe?
Nerve blocks for headaches are generally considered low-risk when performed by trained physicians. Common side effects include brief soreness, tenderness, or numbness at the injection site. Less common risks include infection, bleeding, lightheadedness, and, with steroids, local skin changes. Your physician will review your health history and medications before recommending a block.
Should I get an MRI for my headaches?
Most headaches do not require imaging, because the diagnosis is usually based on your history and examination. An MRI or CT scan may be recommended when there are warning signs, a change in headache pattern, abnormal neurological findings, or a headache after injury. Your physician will explain whether imaging is likely to change your treatment.
Can headaches be cured?
Many headache types cannot be permanently cured, but they can often be controlled well. Identifying triggers, treating neck or muscle contributors, using preventive strategies, and choosing the right procedures may reduce how often headaches occur and how severe they feel. Results vary, and plans are adjusted over time based on your response.