Diagnosis
The diagnosis is usually based on the symptoms and questioning of the patient. In order to find out if there is tension in the shoulder, neck and throat area, the doctor will palpate these areas. If it is a fungus on the scalp (tinea capitis), a smear can be taken from the inflamed and scaly areas and the fungus cultivated culturally. The diagnoses psoriasis and neurodermatitis are made by specific questioning and examination of other body regions such as arms, legs and lower back. Injuries and irritations of the scalp can also be detected by an inspection of the head.
Associated symptoms
Depending on the cause, the accompanying symptoms may vary. On the one hand, itching and tingling on the scalp can occur even without external findings. In addition, hair loss often occurs in connection with trichodynia.
The pain can sometimes be so severe that it is accompanied by dizziness. If a fungal infestation is the cause of the pain, visible red, circular and scaly rashes on the scalp appear. In these areas, the hair usually falls out.
If tension is to blame for the painful scalp, this is often preceded by neck or shoulder pain. A painful scalp can also be a side effect of flu together with typical symptoms such as rhinitis, sore throat, general malaise, fever and also earache. If the scalp is dried out or irritated by shampoos or other care products, the scalp can cause dandruff as well as pain.
More information on this topic: Burning scalpMany patients who suffer from aching scalps report hair loss. This is also found exactly in the places where the head hurts. This hair loss is explained by an undersupply of blood to the scalp.
If there is tension in the shoulder, neck or head area, vessels can be affected. Under the scalp there are many small blood vessels that nourish the scalp, muscles and hair. If these are compressed by excessive muscle tension, they cannot transport a sufficient amount of blood and nutrients to the scalp and hair.
If the scalp is not sufficiently supplied with oxygen and nutrients for a longer period of time, hair loss occurs in these areas. However, hair loss can usually be reversed by adequate treatment of the cause – such as stress or tension due to incorrect posture. If the pain occurs especially in the area of the ear, neuralgia can be the cause.
This is a sudden, severe nerve pain. These disappear after a few seconds, but can then reappear shortly afterwards as a series. The reoccurrence can occur up to 100 times a day.
In the ear, the main causes of pain are the sensitive branches of the trigeminal nerve.Here too, pain is caused by a reduced supply to the nerve. Typical here, however, is the one-sided occurrence of the pain. Ear pain and aching scalp can also occur in connection with an ear infection.
These can be various infections, whereby the actual ear pain spreads to the surrounding skin. For example, the pain can be triggered by an inflammation of the middle ear (otitis media) or an inflammation of the external auditory canal. A so-called shingles on the ear (zoster oticus) can also cause pain on the skin in the area of the ear.
In most cases, this results in typical, grouped vesicles on and around the affected ear. The pain can be felt several days before the skin symptoms appear. If the scalp hurts when touched, the nerves are irritated and hypersensitivity occurs.
This hypersensitivity can occur for almost all causes as a concomitant symptom. Often, however, there is a strong sensitivity to touch in combination with neuralgia. In this case the nerves are highly irritated and can no longer react adequately to normal stimuli and therefore signal even slight touches to the brain as pain.
If pain occurs in the scalp area on one side only, nerve pain (neuralgia) is often responsible. In most cases, the nerves that run along the back of the head over the side towards the forehead are responsible. These nerves are called the major occipital nerve and the minor occipital nerve, and the pain emanating from them is called occipital neuralgia.
The causes of nerve pain can be infections as well as problems with the intervertebral discs, which pinch and irritate the nerves. In addition, muscle tension in the neck or osteoarthritis in the cervical vertebral joints can also be responsible for neuralgia. The pain is described as stabbing or drilling and the head is often very sensitive to touch.
The duration of the pain varies. It can be as little as a few minutes or as long as several days. One-sided, pulling pain can also be caused by unilateral sinusitis or sinusitis of the maxillary sinus.
If these are not ventilated properly, the pain can spread to one side of the head. An irritated or inflamed wisdom tooth can also cause unilateral, radiating headaches. If it is not removed, these can also occur again and again.
Bilateral pain on one side of the scalp is common with herpes zoster (facial rose) on the head and face. Herpes zoster is caused by a reactivation of the Varicella zoster virus, which is the primary infection causing chickenpox. The first symptom, in addition to general weakness and a feeling of illness, can be a severe headache, which presses and usually originates from the back of the head.
The scalp and hair are also often sensitive to touch. Normally, herpes zoster only occurs on one side. However, since the nerve cords on the scalp branch out in large numbers, the scalp is affected in its entirety and therefore causes complete pain.
Two to three days after the onset of the pain, the typical skin symptoms such as grouped blisters and redness appear. A so-called craniomandibular dysfunction (CMD) – a malposition of the jaw – can also cause dull or pulling pain by affecting the neck muscles, tendons and joints, which usually radiate from the back of the head to the temples. Touch sensitivity of scalp and hair is also typical.
