Migraine pain most commonly strikes around the eyes, the temples, and the forehead. In a study of over 1,200 migraine patients, 67% reported pain in or around the eyes, 58% at the temples, and 56% across the forehead. But migraine can show up in places that surprise people, including the back of the head, the neck, the face, and even the abdomen.
The Most Common Pain Sites
The front and sides of the head take the brunt of most migraine attacks. The area around and behind the eyes is the single most reported location, followed closely by the temples and the forehead. These three zones overlap for many people, creating a band of pain across the upper face and front of the skull.
Less intuitively, about 40% of migraine patients report pain at the back of the head (the occipital region), and a nearly identical percentage feel it in the neck. Neck pain in particular is drastically underrecognized as a migraine symptom. A meta-analysis pooling data from 24 studies found that 77% of people with episodic migraine experience neck pain during attacks, rising to 87% in those with chronic migraine. That rate is 12 times higher than in people without headaches. Some people feel neck stiffness or aching as the first sign of an approaching migraine, well before head pain begins.
Why Pain Centers Behind the Eyes
The reason so many migraine attacks feel like they’re drilling through your eye socket comes down to nerve anatomy. The trigeminal nerve, the main sensory nerve of the face and head, has three branches. The first branch covers the forehead, upper eyelids, and the front two-thirds of the scalp. Critically, this same branch also supplies the pain-sensitive membranes lining the brain, the major blood vessels at the base of the brain, and structures deep inside the skull.
When a migraine activates pain signaling in those internal structures, the brain can’t precisely locate the source. Instead, it interprets the signals as coming from the skin and tissue supplied by that same nerve branch, which is the area around the eye, the forehead, and the top of the head. This process, called referred pain, is why a migraine originating deep inside the skull feels like it’s sitting right behind your eyeball.
The second and third branches of the trigeminal nerve cover the mid-face (cheeks, upper teeth, sides of the nose) and the lower face (jaw, lower teeth, chin, and the area near the ears). When these branches get involved, migraine pain can spread into the cheeks, the jaw, or around the ears, which is one reason migraine is so frequently confused with sinus or dental problems.
One Side or Both?
Migraine is classically described as one-sided, and many adults do feel pain predominantly on the left or right. About 40% of adults report clearly unilateral pain during a full-blown attack. But plenty of migraine episodes involve both sides, especially as the attack progresses and pain spreads.
Children are different. Only about 10% of kids with migraine report one-sided pain. Instead, children typically feel pain across the entire head, and the back-of-the-head pattern that’s common in adults is relatively rare in younger patients. This bilateral presentation in kids is one reason pediatric migraine often goes undiagnosed or gets attributed to something else.
Scalp and Skin Sensitivity
During a migraine attack, pain isn’t limited to deep, throbbing ache. Between 60% and 80% of migraine patients develop a heightened skin sensitivity called cutaneous allodynia, where normally painless touch becomes uncomfortable or outright painful. Brushing your hair, wearing a ponytail, resting your head on a pillow, or even feeling the wind on your face can hurt.
This sensitivity is most common across the scalp on the same side as the headache, particularly in the forehead-to-crown zone supplied by that first branch of the trigeminal nerve. But it can extend to the neck and even the arms and hands. About 66% of people who develop this sensitivity during an attack feel it beyond the head, into the upper neck area. The sensitivity tends to build over the course of the attack, which is why treatments generally work better when taken early, before it has a chance to set in.
When It Feels Like a Sinus Headache
Many people who think they have sinus headaches actually have migraine. The nerves activated during a migraine attack are the same nerves that supply the sinuses, eyes, teeth, and jaw. This means migraine can produce pressure and fullness around the cheekbones, behind the eyes, and across the bridge of the nose, mimicking a sinus infection almost perfectly. Some people even get a runny or stuffy nose during an attack, further blurring the line.
A true sinus headache, technically called rhinosinusitis, is rarer than most people assume. The distinguishing feature is thick, discolored nasal discharge from an active viral or bacterial infection. If you get recurring “sinus headaches” with clear or no discharge, especially ones that throb and worsen with movement, those are very likely migraine.
Migraine Pain Below the Head
In a less common but well-recognized variant, migraine pain shows up in the abdomen rather than the head. Abdominal migraine causes moderate to severe belly pain, usually centered around the navel, lasting anywhere from a few hours to a few days. It primarily affects children, with an average age of onset around 7 and an estimated prevalence of 1% to 4% among school-aged kids. It occurs in adults too, though less frequently. Episodes often come with nausea, vomiting, and loss of appetite, and many children who experience abdominal migraine go on to develop typical head-pain migraine later in life.
How Location Can Shift Over Time
Migraine pain doesn’t always stay in one place, either within a single attack or across your lifetime. A single episode might start at the base of the skull, migrate forward to the temple, and settle behind one eye. Over years, your typical pain location can shift entirely. Someone who always felt migraine in the right temple during their twenties might find it moving to the back of the head or becoming bilateral in their forties. These shifts happen because the underlying nerve pathways share connections and can activate different referral zones depending on which structures are most involved in a given attack. A change in pain location doesn’t necessarily mean something new is wrong, but a sudden, dramatic shift in the character or location of your headaches is worth mentioning to your doctor to rule out other causes.