What's this sharp pain on the surface of my head?

This has plagued me for years now. It happens infrequently, but when it does it’s a doozy. I say “pain on my head,” not “in my head,” because it is not the same thing as a headache. A headache is spread all over the head, or a half of it, is rather dull, continuous, and feels like it’s inside the skull.

This pain I’m asking about is [ul]
[li]more on the surface: on the surface of the skull bone or in the skin[/li][li]localized in a specific small spot no bigger than a nickel, usually behind the ear[/li][li]very sharp and stabbing, like a spike being hammered in[/li][li]intermittent: it happens for a few seconds up to a minute, then stops and later starts again[/li][/ul]

When I have been to doctors asking about it, they don’t understand that I am not talking about a headache. I don’t know what to call it, though. Most doctors these days don’t have the patience to listen while you explain symptoms in detail; they’re in a hurry to get rid of you.

I usually get this in winter, and at night. Cold seems to aggravate it. It only happens a two or three times a year.

Can anyone explain what this is? What causes it? Is there a scientific name for it?

i’m guessing that the cold over-excites one of the sensory nerve endings to the scalp, causing pain in it’s receptive field, which explains why it’s so localised.

the same nerve fibres sense temperature and pain, so there might be some “crossed wiring” somewhere.
i don’t know what “behind the ear” actually means in your case.

it could be something involving the mastoid bone or the facial nerve if it’s near the angle of the jaw, the higher up and further back the pain, the less likely that is.

sorry i can’t help more

try searching for cranial or facial neuritis and see if any of your symptoms match up.

This could be what’s called an “ice-pick headache.” I get them, too. I did a little Googling a while back, and the general conclusion I got was that they’re well-documented, poorly understood, and not generally a sign of any serious problem. I get them typically in the same place, too, although mine are typically about a third of the way from the top of my head to my right ear.

Does putting pressure on it relieve the sensation at all?

See if this sounds like it: Ideopathic Stabbing Headache

I did some Googling as well because every so often I get one in my left temple. They come out of nowhere, disappear just as quickly, and the last one dropped me to the kitchen floor going “owieowieowieowieowieowie!”


Have you been bitten by a spider lately? It may be your Spider-Sense[sub]tm[/sub] tingling.

I get this pain in the area you described (as well as different points on my face). My doctor diagnosed it as “atypical neuralgia.” You mention feeling the pain when it’s cold…cold is a known neuralgia trigger.

More info: http://facial-neuralgia.org/

I have exactly the same sensation you described. It is not a throbbing pain like a headache, but on the surface of my head, small area, hurts when I push slightly. To the left of the top of my right ear. Just happens now and then. Very odd, but somewhat comforting to see someone else describe it accurately.

Yay zombie.

It could be referred pain from a muscle in your neck or face. But I have no idea which muscle. Seeing a trigger point therapist ‘could’ be helpful to see if they can find anything.

I saw one who could squeeze my sternocleidomastoids and cause referred pain on the top of my head. That is where the charts said one of the spots of referred pain occurs from that particular muscle.

Could be mastoiditis.

I don’t know.

OP PM’ed.

I have had this same thing for most of my adult life. I haven’t been able to trace it back to anything such as weather. It seems to hit a few times a year and hit several continuous days for several hours at a time. Not a horrible pain just aggravating and sensitive to the touch. I have always suspected it was related to stress somehow.

Forgot I had posted this thread. I finally figured out what it was some years ago and have mentioned it a few times since. Props to gallows fodder above for being the first to cite the term neuralgia. It’s occipital neuralgia. It can occur anywhere on the lower back of my head or upper neck, and often right behind my ears. It tracks with the placement of the occipital nerve. Sometimes it can be triggered (or aggravated) by cold drafts of air on my occiput or ear.

I’ve learned to manage it by wrapping up my head and neck warm if an attack is imminent (except that it usually strikes with no warning), by getting rest, and by gently massaging the right pressure points back there. Which points? I can’t say. I have to explore each time and find the exact spots where a little pressure might mitigate the pain a bit. IME getting rest to decrease stress is very important. Sitting up and attempting to continue working at my desk will aggravate it. I go lie down with the area wrapped up warm in a pashmina and take it as easy as possible. When it gets really bad it’s debilitating like nothing else. When it goes from being a sharp ice-pick pain to feeling like a traumatically mechanical crushing of part my skull is the worst. Getting rest and de-stressing as soon as possible seems to stave off the worst levels of it. I have a small pressure point manipulator called Knobble II that seems to help a little.

While I have found ways to hopefully mitigate it, I still don’t know what causes it or how to prevent attacks, let alone cure it. It’s a hell of a bitch to live with, but I’ve read that trigeminal neuralgia is the worst of all, so I’m thankful at least it isn’t that.