Pain in back of eyes and headache

Physical discomfort due to an eye disease or other condition. Headache behind the eye feels like it is coming from inside the head, from the sinuses or from the back of the eye itself. A headache behind the eye may or may not throb with your pulse. Where you feel pain is not necessarily an indicator of what’s causing the pain.

Headache behind the eye may be associated with:

Headache behind the eye can be similar to these symptoms:

Garza I, Robertson CE, Smith JH, Whealy MA. Headache and other craniofacial pain. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 102.

Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17(1):75-83. PMID: 29174963www.ncbi.nlm.nih.gov/pubmed/29174963/.

Rozental JM. Tension-type headache, chronic tension-type headache, and other chronic headache types. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.

Last reviewed on: 11/9/2021

Reviewed by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Dealing with any kind of headache is a serious pain, but a headache behind your eyes is a unique form of torture. After all, you rely pretty heavily on your eyesight to help you get around, so when every glance and blink causes new waves of pain, it can completely derail your day.

Unfortunately, eyeball-pulsing headaches happen, and there’s not one set cause for them, Medhat Mikhael, MD, pain management specialist and medical director of the nonoperative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells SELF. “There are several reasons why one might have a headache behind the eyes,” he says.

Knowing the source of your eye headache can help you pinpoint the best treatment for it—and get some relief, stat. With that in mind, these are some of the most common reasons for feeling a headache behind the eyes and what to do when one threatens to ruin your day.

1. You have a tension headache.

A tension headache is the most common type of headache, according to the U.S. National Library of Medicine (NLM). You can get a tension headache for a slew of different reasons, including stress or muscle tension in your neck, scalp, or head. Tension headaches typically make you feel like there’s a band that’s squeezing your head, causing pain in your forehead or on both sides and the back of your head, according to the Mayo Clinic.

But that band of pain can extend to behind your eyes too, Dr. Mikhail says. “Muscle tightness causes the headache,1 and the muscles around the eyes can be affected,” he says. “That can cause pain around the eye and behind the eye.”

If you’re playing headache detective, keep in mind that tension headaches tend to come on slowly and usually cause mild to moderate pain, according to the Cleveland Clinic. In general, they feel like a “dull ache,” Amit Sachdev, MD, the director of the division of neuromuscular medicine at Michigan State University, tells SELF.

Treatment for tension headaches usually involves pain-relieving medications like aspirin, ibuprofen, or naproxen sodium, or meds that combine a pain reliever like aspirin or acetaminophen with caffeine, per the Mayo Clinic.

Prefer to go the nonmedicated route for relief? Resting, using an ice pack on your head, or taking a long, hot shower can help. If tension headaches are a regular thing for you, talk to your doctor about maintenance medication that might help. Some people may find that certain stretches and exercises, practiced under the guidance of a physical therapist, can also help relieve the muscle tension that contributes to tension headaches, per the Mayo Clinic.

2. It’s actually a migraine attack.

If you’ve had a migraine attack in the past, you usually know what you’re up against. But if you haven’t or you’re not sure, it never hurts to recap: A migraine attack can cause an intense and severe headache that usually results in a pounding or throbbing pain on one side of your head, according to the NLM. Migraine pain “can cluster in many locations” including around the eyes, Dr. Sachdev says. “Why the eyes are very commonly affected is unknown.”

Migraine episodes can come with other symptoms like nausea, dizziness, and sensitivity to light, noise, or smell. Not-so-fun fact: People assigned female at birth are three times more likely than people assigned male at birth to have migraines, the Cleveland Clinic says. Migraine causes are complex, but the following may trigger a migraine in some people:

• Emotional stress
• Missing a meal
• Sensitivity to certain chemicals and preservatives in foods
• Too much caffeine or withdrawal from caffeine
• Using pain-relieving medication too much
• Hormonal changes (like having your period or going through menopause)
• Flashing lights, fluorescent lights, or even sunlight

Migraine attacks typically move through four stages, but not all people go through all of them: A prodrome, which signals to your body that a migraine is coming; an aura, which can cause visual changes; an attack, which causes the pain symptoms people classically link with migraine; and a post-drome, where you can feel drained, weak, dizzy, moody, confused, or even elated, according to the Mayo Clinic.

Migraine treatment is similar to what you’d do for a tension headache. However, the Mayo Clinic says there are many additional options for pain relief, including prescription medications that target head pain (like triptans) and anti-nausea drugs (to help with nausea and vomiting).

3. You’re dealing with a cluster headache.

A cluster headache is all about the eye pain—it usually causes pain in and around one of your eyes or on the side of your head, according to the Mayo Clinic. Cluster headaches typically happen in phases called “cluster periods,” which can last anywhere from a few weeks to multiple months and cause frequent attacks (which can occur daily or multiple times per day) that last from 15 minutes to 3 hours.

A cluster headache will often wake you up in the middle of the night with intense pain in or around one eye on one side of your head. “The pain behind the eye is severe,” Dr. Mikhail says.

Cluster headaches can also cause symptoms on the same side as your head pain, like red or watery eyes, a stuffy nose, forehead sweat, and eyelid drooping or swelling, according to Johns Hopkins Medicine. These headaches seem to be linked to the sudden release of histamine or serotonin in the body. When in a cluster cycle, attacks may be triggered by alcohol, moving to a high altitude, bright light, exercise, heat, and foods with nitrates (like bacon or lunch meat).

The good news: Cluster headaches are rare. But because they come on so fast and go away quickly, cluster headaches can be tricky to treat. However, treatments can range from things like supplemental oxygen to triptans and local anesthetics (like lidocaine that’s breathed into the nose). There are also a number of preventative treatments that can be given at the beginning of a cluster period to suppress attacks.

4. You have a sinus headache.

Sinus headaches are a tricky thing to parse out, especially given that most of the time what people refer to as a “sinus headache” is migraine with nasal symptoms, the Cleveland Clinic says. That said, sinus headaches are an actual thing that happens when a sinus infection causes pain and pressure in the sinuses.

They usually feel like you’re having pain in your forehead, the bridge of your nose, or behind your cheekbones, and the pain usually gets worse when you move your head suddenly, per the Cleveland Clinic. This “very commonly causes a headache behind the eye,” Dr. Sachdev says. Since a sinus headache is usually a tip-off that you have a sinus infection, it tends to come with other symptoms like a stuffy nose, fever, and puffiness in your face.

If your “sinus headache” is actually a migraine attack, you’ll get the best relief from using treatments designed for migraine. But if it’s a legit sinus headache, your doctor will run some tests to confirm if it’s being caused by a viral, bacterial, or fungal infection. They can prescribe you proper treatment to clear things up if needed, but most sinus infections tend to clear up on their own. Other things you can do to get relief, according to the Cleveland Clinic:

• Lay a warm compress over your eyes and other areas where you’re having pain
• Use a decongestant to reduce swelling and drain mucus
• Use saline nasal spray to thin mucus
• Use a vaporizer or inhale steam from a pan of hot water

5. You’re struggling with eyestrain.

Eyestrain refers to your eyes getting tired after intense use, like when you drive for a long time or stare at your computer for hours on end, the Mayo Clinic says. This can lead to symptoms like a headache behind your eyes, having watery or dry eyes, feeling like your eyes are sore or burning, having increased sensitivity to light, and feeling like you can’t keep your eyes open.

While eyestrain usually goes away when you do your eyes a solid and give them a break, Dr. Sachdev says it’s no joke. “Stress on the muscles around the eye can be painful,” he says. If you suspect that you’re having eyestrain and you want relief, the Mayo Clinic recommends adjusting the lighting of your screens, giving yourself regular eye breaks to help your eyes focus at different distances, using lubricating eye drops, and increasing the humidity in the room.

So how can I stop having headaches behind my eyes?

It really depends. If you can pinpoint the cause of your headaches, it’s a good idea to try some of the treatment methods we just covered to help you feel better. “In most cases, over-the-counter medications are effective,” Dr. Sachdev says. But if headaches behind your eyes are a regular thing for you and they’re messing with your ability to go about your life, Dr. Sachdev says it’s time to rope in a professional for help.

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