Headache behind the ear: causes, treatment and more

A different type of headache.

Most people have experienced a headache at some time in their lives. But not all headaches are the same. In fact, there are more than 300 types of headaches.

It is unusual for the headache to occur exclusively behind the ear. When the pain behind the ear is not relieved, you will want to find out what is causing it so you can find relief.

Read on to learn more about the headache behind the ear and when to see a doctor.

What causes the pain behind the ear?

It is not always possible to identify the cause of a headache. If you have persistent pain behind the ear, there are some potential causes.

Occipital neuralgia

Occipital neuralgia is a type of headache caused by a lesion or pinched nerves in the neck. Pinched nerves can happen when you keep your neck bent for a long time. It can also be due to arthritis in the neck and shoulders.

Occipital neuralgia can cause pain and palpitations in the neck, back or on one side of the head and behind the ear. Some people feel pain in the forehead or behind the eyes. It can even cause sensitivity on the scalp. The pain usually starts in the neck and moves up.


The mastoid bone lies behind the ear. Mastoiditis is when bacteria cause the bone to become infected or inflamed. This may be the result of an untreated infection of the middle ear. Anyone can get mastoiditis, but it is more common in children.

Signs of mastoiditis include redness, swelling and discharge from the ear. It can cause headache, fever and hearing loss in that ear.

Temporomandibular Joint (TMJ) Disorder

The temporomandibular joint is the joint that helps open and close the jaws. If it is misaligned, injured or damaged by arthritis, it can not be opened without problems. The joint can grind and creak when the mouth is moved.

TMJ disorder usually makes chewing difficult. You may feel the joint scrape or hear a click or snap when moving the jaws. Usually, it also involves pain in the jaw area. In some cases, the joint may be blocked so that it can not open or close its mouth. This situation may be fleeting or require medical intervention.

Dental problems

Problems with the mouth and teeth can cause referred pain. It is entirely possible that the headache behind the ear comes from an impacted tooth or with abscesses or other dental problem. Your dentist will be able to identify the problem in the exam.

Signs of dental problems can include bad breath, tenderness in the gums, or difficulty chewing.

Get more information: Recognize the warning signs of 5 dental health problems »

When to see a doctor

Anyone can have a brief pain or headache. It does not necessarily require a visit to the doctor. You should schedule an appointment with the doctor if:

  • the pain intensifies

  • you suspect you have an ear infection

  • You have already been treated, but you do not feel better

  • you are having a fever

  • you have unexplained weight loss

Seek immediate medical attention if you have:

  • severe and sudden headache

  • a closed jaw

  • high fever, nausea or vomiting

  • Confusion or changes in personality.

  • lethargy

  • seizures

These could be signs of a serious medical condition.

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Your doctor will probably start with a physical exam, which includes a look in your ears. You may also need an ear culture and some blood tests. If you appear to have an inflammation or infection in your ear, you may be referred to an ear, nose and throat (ENT) specialist.

If your doctor suspects occipital neuralgia, you may be given a nerve-blocking anesthetic. If this provides pain relief, your doctor can confirm the diagnosis of occipital neuralgia.

To diagnose TMJ disorder, your doctor will probably refer you to a specialist or oral surgeon. The diagnosis can be confirmed by imaging tests.

If you have a persistent headache without an obvious cause, the next step may be to see a neurologist. After making a history of your symptoms and performing a neurological examination, the diagnosis may include imaging tests such as:

  • bone scan

  • Computed tomography (CT or CT scan)

  • magnetic resonance imaging (MRI)

Consider seeing a dentist for a complete checkup. This can help rule out dental problems as the cause of your headache.

How is it treated?

While waiting for the diagnosis, you can find temporary relief with over-the-counter medications. You can also apply an ice pack in the painful area. If you also have neck pain, heat therapy may help loosen the neck muscles. Other treatments depend on what is causing the headache.

Occipital neuralgia

Occipital neuralgia can be treated with analgesics and anti-inflammatory medications. Local nerve blockers and muscle relaxants may also be helpful. In severe cases, corticosteroids can be injected directly at the site of the problem.

Since occipital neuralgia is caused by problems in the neck, try to avoid keeping the head and neck in the same position for too long. If you work with a laptop or handheld device, try to change position and look up and away from the device frequently.

Complementary therapies can also help. These include:

  • Heat therapy for your neck.

  • massage

  • physiotherapy and exercise

  • relaxation and meditation


Mastoiditis is usually treated with antibiotics. If the infection is severe enough, you can receive antibiotics intravenously. If that does not work, you may need to drain your middle ear. This procedure is known as myringotomy. Very serious cases may require the removal of part of the mastoid bone, which is known as a mastoidectomy.


If you have TMJ, certain behaviors, such as grinding or clenching your teeth, can make it worse. There are several treatments that can help ATM, including:

  • Analgesics, anti-inflammatories or muscle relaxants.

  • oral splints or mouth guards

  • physical therapy

  • Removal of joint fluid, known as arthrocentesis.

  • corticosteroid injections

  • arthroscopic surgery

  • open joint surgery

Complementary therapies may include:

  • acupuncture

  • Meditation and relaxation techniques.

  • biofeedback


With rest and treatment, pain due to occipital neuralgia should improve. Continuous stress in the neck can cause the symptoms to return.

The symptoms of mastoiditis should improve within a few days of starting antibiotics. Most people recover completely. To ensure that the infection has disappeared, you must continue with the full course of antibiotics, even if the symptoms have improved.

In some cases, ATM may improve without treatment. The recovery time depends on the severity of the condition and the treatment.

Chronic headaches may require long-term management.

How to prevent headaches.

To reduce the risk of aggravating a headache behind the ear, try these tips:

  • Consider your position. Crouching or keeping the head and neck in the same position for a long time can cause punctures in the nerves.

  • Limit your use of handheld devices. When you use a handheld device, you tend to keep the neck tilted down.

  • Take a break. If you work at a desk all day, get up and walk a few minutes every hour. Frequent breaks can prevent stiff neck and shoulders.

  • Eat on time. Skipping meals can cause headaches.

  • Rest well. Stress and fatigue are risk factors for headaches. Sleep well tonight going to bed at the same time and get up at the same time every day.

Reference: https: //www.healthline.com/health/headache-behind-ear


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