Possible causes of a headache behind the ear include nerve injury, an infection, and jaw problems. Medical and alternative treatments can help relieve the pain.

A headache behind the ear refers to any pain originating from that specific head area. Headaches that occur exclusively behind the ear are fairly unusual.

This article explores the signs and symptoms of headaches behind the ear and details what causes them. It also discusses treatment options for relieving pain and associated symptoms.

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There are several possible causes of a headache behind the ear. These include the following:

Occipital neuralgia

One possible cause of a headache behind the ear is occipital neuralgia.

Occipital neuralgia occurs when the occipital nerves are injured or inflamed, causing pressure or irritation. These nerves run from the top of the spinal cord up through the scalp,

The pain usually starts on one side of the head but can spread to both sides. Pressure or irritation can result from inflammation, overly tight muscles, or a traumatic injury.

This type of headache can feel similar to a migraine, cluster headache, or tension headache.

People with occipital neuralgia describe the pain as piercing and stabbing. The pain typically lasts from a few seconds to a few minutes.

It can feel like being jabbed by a sharp instrument in the following places:

  • the upper neck
  • the base of the head
  • behind the ears

Often, doctors cannot find a cause for occipital neuralgia.

Mastoiditis

Mastoiditis is a type of ear infection. It involves an infection of the mastoid bone, the bone directly behind the ear.

It is more common in children than adults, and most cases are in infants under 2 years of age.

In addition to a headache behind the ear, mastoiditis can cause:

Anyone with these symptoms should seek medical help as soon as possible to prevent complications from arising.

TMJ disorder

The temporomandibular joints (TMJ) are the ball and socket joints of the jaw. Problems with these joints can lead to headaches and other symptoms. Problems with the TMJ are called TMJ disorders.

Most people with TMJ inflammation feel pain in the jaw and as pain behind the ear, but there may also be:

TMJ can result from:

What is the link between TMJ disorders and headaches?

Some headaches behind the ears need urgent medical attention to address an underlying cause. In other cases, home remedies may bring relief before or in addition to medical care.

Some home treatments that may help include:

For some approaches, such as massage and biofeedback, there is not enough evidence to confirm they will help. As with any treatment options, a person should speak with a doctor before trying any new remedies.

What are some home remedies for ear pain?

Sometimes, a person will need medical treatment for an underlying cause of a headache behind the ears.

Occipital neuralgia

For occipital neuralgia, a doctor may prescribe medications such as:

Interventions for occipital neuralgia include:

  • Nerve decompression: A surgeon removes any structures compressing the nerves.
  • Occipital nerve modulation: A doctor implants a nerve stimulator to deliver electrical pulses to the occipital nerves. These pulses may help block pain messages to the brain.
  • Radiofrequency ablation or cryosurgery: These destroy nerves or structures that are causing pain.

In rare cases, a person may need surgery. This may happen if there is a structural reason for the pain and it does not stop or improve with other treatments.

Mastoiditis

A person with mastoiditis needs urgent medical attention.

The main treatment for mastoiditis is with antibiotics, but a doctor may prescribe other interventions, such as:

  • making a small hole in the eardrum to allow fluid to drain
  • inserting a tube into the eardrum to allow fluid to drain and enable ventilation
  • surgery to remove infected cells from the mastoid bone

A person may need to spend time in the hospital.

What are some other treatments for ear infections?

TMJ disorder

A doctor or dentist may advise a person to use a mouth guard while sleeping to prevent them from grinding their teeth.

If other treatments do not work, a doctor may recommend injections of Botulinum toxin (Botox) for TMJ dysfunction.

If other remedies do not help, TMJ surgery may be an option.

However, these can have adverse effects and may not be suitable for repeated use. A doctor will administer these in their office.

A person should see a doctor for a headache behind the ears if they experience:

  • ongoing pain
  • severe pain
  • other symptoms, such as a fever

Headaches behind the ear can be painful and worrying. Possible causes include occipital neuralgia, mastoiditis, and TMJ pain.

Anyone who has ongoing or severe headaches behind the ears or additional symptoms, such as a fever, should seek medical advice. Infants who have signs of ear pain need immediate medical attention.

Home remedies can often help manage these types of headaches, but some people may need treatment for an underlying condition.

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