Q. Why do I have off and on neck and head pains?

Answered by
Dr. Thakre Mahendra Shivram
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on May 02, 2020 and last reviewed on: Apr 06, 2021

Hi doctor,

I have neck pain on and off with headaches. My scalp in the back is tender and while cleaning my left ear, I have pain inside the ears. Before three days, I had a headache radiating to the left side of my ears.



Welcome to

I understand your concern. You are having headaches on and off and it seems to be a chronic headache. For the last three days, you are having a new set of headaches and it gets triggered by cleaning your left ear associated with scalp tenderness and pain behind the ears. There are several causes to have pain behind the ears. One of the most common causes of headache is occipital neuralgia. In this condition, occipital nerves are injured or inflamed. The nature of the pain is piercing and sometimes it seems to be throbbing or similar to the feeling of an electric shock. For this pain, you need evaluation by doing a scan.

You can take medications like Carbamazepine or Pregabalin to reduce nerve pain. The other common cause is mastoiditis. It occurs due to the infection of the mastoid bone and it is the bone present directly behind the ear. It can cause headaches behind the ear. Often it occurs associated with fever and discharge from the ears. In your case, it is the likely cause as you have a history of ear trauma while cleaning your ears. Taking anti-inflammatory medication and antibiotics helps a lot.

The other cause is temporomandibular joint inflammation. These joints become inflamed and painful. There are jaw tightness and pain with a headache behind the ears. Lastly, migraine presents in a different manner. As you are having a chronic headache, it can also be a cause in you. It is important to find the exact cause and so it can be treated appropriately.

You need to search your cause according to your red-flag symptoms. The red flag symptoms in you are sudden onset of headache after 50 years of age and increased frequency or severity of headache. There is a new onset of headache with an underlying medical condition, headache with concomitant systemic illness such as fever, neck stiffness, and rash, and neurologic signs or symptoms.

You need medical attention urgently while having these symptoms. For symptomatic relief, you can take over-the-counter anti-inflammatory drugs such as Ibuprofen and Paracetamol, massage your neck muscles, and apply heat packs. If there is swelling, apply cold packs and take a rest in a quiet room.

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