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Headache Behind the Eye? Why It Happens and What Helps

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A headache behind the eyes may feel like a dull ache, sharp stabbing pain, or even throbbing sensations.

What causes this kind of headache? Should you be concerned? And how can you find relief? Here, experts break down the common causes, treatments, and preventive strategies for headaches behind the eyes.

Headache pain behind the eyes can arise from conditions ranging from mild and commonplace to chronic neurological issues.

"Pain behind the eyes is a symptom, not a diagnosis," says Hope O’Brien, MD, a neurologist and the founder and CEO of Headache Center for Hope, a headache treatment clinic in Cincinnati. Evaluating other symptoms that occur alongside pain behind the eyes can pinpoint the underlying issue.

Here are the most common causes of headache pain behind the eye.

Tension Headaches

Tension headaches are the most common type of headache, often described as a band of pressure around the head, says Fawad Khan, MD, a neurologist at Ochsner Medical Center in New Orleans. You may also experience tight neck and shoulder muscles or sensitivity to light and sound.

That band of pressure typically causes pain above the eyes, which can sometimes radiate behind the eyes, too, according to Sarah Benish, MD, a neurologist and the medical director of neurosciences at M Health Fairview Clinic and Surgery Center in Minneapolis. Typically, both eyes are affected.

While the exact cause is unknown, there may be several factors that can trigger a tension headache, including stress and muscle tension.

 Lifestyle factors like hunger and dehydration can also contribute to these headaches, says Ann Hoang-Tienor, MD, a neurologist at Hennepin Healthcare in Minneapolis.

Fortunately, tension headaches typically aren’t cause for concern. Though they can occur often and create discomfort, they’re not life-threatening and can be treated at home, says Dr. Benish.

Migraine

A migraine is a neurological disease that can cause severe headaches, often with intense throbbing pain on one side of the head.

“What's happening in the brain is that a nerve located behind the eyes — the trigeminal nerve — is activated,” says Dr. O’Brien. When this nerve is triggered, it releases chemicals that can cause pain in the forehead or behind one or both eyes.

Here are other common migraine symptoms to look out for:

  • Fatigue
  • Nausea or vomiting
  • Difficulty concentrating
  • Mood changes
  • Vision changes
  • Muscle weakness
  • Sensitivity to touch, light, sound, or smells
  • Numbness and tingling
  • Dizziness
  • Stiff neck
Though the severity and length of headaches associated with migraine can vary from person to person, they’re typically more serious than a tension headache and often recur throughout your life. Triggers also vary, though common ones include stress, poor sleep, and skipping meals.

Sinusitis

An infection in your sinuses — also called sinusitis — can cause a sinus headache, often felt as pressure or pain behind your eyes, cheeks, and forehead.

According to O’Brien, it’s easy to confuse sinus headaches and headaches that are a symptom of migraine, as some of the trigeminal nerve irritation that occurs during migraine-related headaches can also cause pain around the sinuses.

Unlike headaches from migraine, however, sinus headaches occur when inflammation and congestion changes the pressure in your sinuses, leading to head pain.

To tell the difference between a headache associated with migraine and a sinus headache, watch out for additional symptoms like nausea, vomiting, and light or sound sensitivity — these are all signs that your headache is due to migraine.

Cluster Headaches

“A cluster headache is a type of headache that causes intense stabbing pain behind the eye or in the eye,” says Benish. “This is a severe and debilitating type of headache that often causes people substantial disability,” she adds.

According to Benish, a cluster headache is often accompanied by additional symptoms like:

  • Eyelid drooping
  • Redness in one eye
  • Tearing in one eye
  • Runny nose on one side
  • Flushing on one side of the face
  • Agitation and trouble sitting still
In addition to causing symptoms on one side of your face, cluster headaches stand out because of their distinct patterns of occurrence. They often strike in cycles called "cluster periods," marked by repeated attacks separated by longer, headache-free intervals.

 These headache attacks can last anywhere from 15 minutes to three hours and recur throughout the day, says Dr. Khan.
The cause of cluster headaches is unclear. It may have to do with genetics, dysfunction in your brain’s hypothalamus (an area of the brain that produces hormones that regulate body temperature, heart rate, mood, and hunger), or irritation of the trigeminal nerve.

Eyestrain

Sometimes pain behind the eye can signal issues with the eye itself, says O’Brien. Staring at screens for prolonged periods, poor lighting, or uncorrected vision problems can strain the eye muscles, leading to headaches.

Other symptoms of eyestrain include:

  • Sore, burning, or itching eyes
  • Sensitivity to light
  • Blurred vision
  • Watery or dry eyes
This type of headache behind the eye usually isn’t serious and can be resolved by resting your eyes, taking a break from screens, or wearing appropriate prescription lenses.

Other Possible Causes

Most cases of pain behind your eye can be attributed to headache or eyestrain. That said, there are less-common causes of headaches to note.

Glaucoma, for example, is a condition that causes increased pressure in the eye, damaging your optic nerve (which carries information from the eye to the brain) and leading to vision loss. Headaches and severe eye pain are two common symptoms.

Thyroid eye disease can also cause pain behind the eyes. This autoimmune condition causes inflammation in your eye tissues, leading to pain in or behind your eye that’s worse when looking up, down, or sideways.

Similarly, eye conditions like optic neuritis (which occurs when inflammation causes damage to the optic nerve) and orbital inflammation (swelling of the tissues surrounding the eye) can contribute to headaches behind the eyes, says Khan.

A pinched nerve in your neck (often the result of whiplash or a fall) can sometimes cause pain behind your eye, says Khan. Myofascial pain syndrome — a condition that causes pain in your head and neck muscles, likely due to muscle overuse or injury — can also cause pain behind your eye.

Brain tumors or vascular issues are rare but serious conditions that may present with additional symptoms like vision loss, numbness, or persistent pain. But these conditions are so rare that it’s unlikely they’re the cause of your pain, according to O’Brien.

How you treat a headache behind your eyes depends on the underlying cause. Here are the most common approaches to easing this pain.

Natural Remedies

Hydration, rest, massage, and hot or cold compresses applied to your head or neck can relieve pain from tension headaches and migraine-related headaches.

Over-the-Counter Medications

Over-the-counter (OTC) pain relievers like ibuprofen, aspirin, or acetaminophen can provide temporary relief for tension headaches or milder headaches from migraine.

Overuse of OTC pain relievers can lead to rebound headaches or dependency, so avoid taking these medications more than two days per week if possible.

Prescription Medications

More severe or chronic headaches — like those caused by migraine and cluster headaches — may require treatment with prescription medications.

Certain pain management drugs (such as prochlorperazine, metoclopramide, and 5-hydroxytryptamine) can help relieve your symptoms during an attack.

 Meanwhile, preventive medications like calcium channel blockers and corticosteroids may help reduce the frequency and severity of your headaches.

If these medications are ineffective for headaches associated with migraine, your doctor may recommend other options, such as targeted botulinum toxin injections (like Botox) in the head and neck, says Khan.

If standard treatments don’t provide relief for cluster headaches, your doctor may recommend more intensive treatments like surgery to implant a neurostimulator device that helps keep your symptoms at bay.

Antibiotics

If sinusitis is to blame for your headache behind the eyes and symptoms don’t improve after 10 days, you may need antibiotics to beat the infection.

Depending on the severity of the infection, your physician may recommend additional prescription medication like a nasal steroid spray to reduce inflammation in the area.

Lifestyle Adjustments

Lifestyle changes can play a significant role in managing (or even preventing) headaches behind the eye, particularly if tension headaches or migraine-related headaches are to blame.

For instance, eating regular, balanced meals and staying hydrated can prevent headaches brought on by hunger or dehydration.

Foods like alcohol, caffeine, and preserved meats may trigger migraine headaches and cluster headaches in some people. So, avoiding these products can reduce the likelihood of an attack.

Regular exercise is also key. Moving your body can alleviate tension and improve circulation, both of which can offer headache pain relief.

Improving your posture may offer additional relief. For instance, sleeping with your neck in a neutral angle or adjusting your work setup to be more ergonomic (that is, designed for comfort and ease of use) could relieve any neck and shoulder tension that contributes to your headaches.

Adequate, consistent sleep is critical. Poor sleep quality can increase the frequency and severity of migraine and tension headaches, per research.

Stress Management

Stress is a common trigger for tension headaches and headaches associated with migraine. Reducing symptoms of stress can thus help you relieve headaches behind your eyes (or avoid them altogether).

Common techniques include:

  • Yoga
  • Meditation
  • Journaling
  • Therapy
  • Getting adequate sleep
  • Exercising regularly
  • Eating a nutritious, balanced diet
  • Connecting with loved ones

While occasional headaches might not be cause for concern, certain symptoms could signal an underlying issue that needs medical attention. Here are the signs you should see a doctor about your headaches behind the eyes, according to Dr. Hoang-Tienor.

  • You get headaches more than once a week.
  • You have to take OTC pain relievers more than once a week.
  • Your headaches impact your daily routine.
  • Your headaches aren’t responding to treatments that were once effective.
  • You’re over the age of 50 and experiencing a new type of headache or pain.

Certain symptoms may warrant a trip to the emergency room, says Hoang-Tienor. These include a sudden, severe headache accompanied by:

  • Loss of vision, weakness or paralysis in parts of your body, or slurred speech
  • Head injury or trauma
  • Seizures
  • Fever or vomiting

To prevent a headache behind the eyes, it’s important to identify and avoid your personal headache triggers (more on that shortly), per O’Brien.

According to O’Brien, common strategies to prevent a headache behind the eyes include:

  • Stay hydrated.
  • Eat regular meals.
  • Exercise regularly.
  • Get enough sleep.
  • Reduce caffeine intake.
  • Avoid excessive alcohol use.
  • Manage stress.

Triggers are different for everyone, and can often be tricky to identify.

Still, there are some common headache triggers, says Hoang-Tienor. These include:

  • Stress
  • Alcohol use or withdrawal
  • Caffeine withdrawal
  • Sleep deprivation or over-sleeping
  • Dehydration
  • Hormonal changes
  • Weather changes

Triggers can also be specific to the type of headache you have, particularly in the event of migraine and cluster headaches.

Factors like stress, hormonal changes, poor sleep, weather changes, over-exercising, caffeine, tobacco, skipping meals, bright lights, loud noises, or strong smells can all trigger migraine symptoms like headaches.

Meanwhile, tobacco, alcohol, other substance use, bright lights, heat exposure, eating preserved meats, and certain medications (like sildenafil, which is used to treat erectile dysfunction and pulmonary arterial hypertension) can prompt cluster headaches.

  • A headache behind the eyes is usually a symptom of an underlying issue, like tension headaches, migraine headaches, cluster headaches, sinusitis, eyestrain, and other health conditions.
  • Managing headaches often involves over-the-counter pain medications, prescription medications, rest, and hydration.
  • Frequent headaches or those with neurological symptoms, like vision changes or numbness, should be evaluated by a doctor.
  • Seek immediate care for sudden, severe headaches accompanied by alarming symptoms like loss of vision, slurred speech, or seizures.

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