Tingling, shock-like, or cold sensations at the back of your head, that come and go without any obvious trigger, are typically caused by temporary nerve irritations called paresthesia. They are often harmless and can result from nerves misfiring or being slightly irritated or compressed. The back of the scalp is primarily supplied by the greater and lesser occipital nerves. If one of these nerves is briefly irritated (for instance, due to posture, tension in the neck muscles, or even just moving your head in a certain way), it could cause a strange, fleeting sensation.
Other terms you may find online include:
Neuropathy: a blanket term for any disease that affects a nerve. Paresthesia may be a symptom but neuropathies tend to develop over long periods of times and are associated with systemic issues like diabetes, vitamin deficiency, and chronic alcohol use.
Dysesthesia: an unpleasant, abnormal sensation that might be very painful, but unlike paresthesia it is evoked by a neutral stimulus such as a light touch. You might read that this condition is associated with multiple sclerosis, diabetes, etc. but the key difference is that it can be consistently provoked and is not spontaneous or temporary.
How long does it last?
Paresthesia sensations typically last seconds to minutes at a time, and may persist for a few days, then resolve without any specific treatment. The exact cause may be indeterminate (“idiopathic” as they call it in medicine) unless you can find a way to re-elicit the sensations.
First things to try:
Gentle massage of affected area: If rubbing the area makes the feeling go away briefly suggests that it might be a mild, local nerve phenomenon—gentle pressure or massage can temporarily disrupt the abnormal signals.
Improve posture and de-stress: Muscle tightness at the base of the skull can sometimes stimulate or compress nearby nerves. Extended screen time with the head tilted can play a role. Limit screen time and try gentle neck stretches and relaxation exercises to ease any muscle tension that could be irritating a nerve.
If the sensations are particularly bothersome:
Warm compress: Try putting a hot towel over the back of your head if the sensation is particularly bothersome, again with the intention of disrupting the nerve misfiring or redirecting attention away from it.
Topical anesthetic: If the sensations are distracting during work, social interactions, or other important tasks, you can consider applying a small amount of lidocaine gel such as Neosporin with lidocaine (which you can also use for first-aid applications so it’s not a waste) to the area of paresthesia.
When to seek medical attention:
Not resolving after 1 week: Paresthesias of the scalp should resolve and any nerve irritation should heal on its own within a few days. If persistent, you can consider consulting a doctor.
Additional symptoms: If it’s happening often, gets worse, or if other symptoms (pain, numbness down your arm, headaches, dizziness, etc.) start showing up, it would be a good idea to get it checked by a healthcare provider.
Citations:
McKnight, J. T., & Adcock, B. B. (1997). Paresthesias: a practical diagnostic approach. American family physician, 56(9), 2253–2260.
Castelli, G., Desai, K. M., & Cantone, R. E. (2020). Peripheral Neuropathy: Evaluation and Differential Diagnosis. American family physician, 102(12), 732–739.
