The most common causes of tightness and dizziness in the back of the head are cervical spondylosis, neck strain, and neck exertion. Because the sensation in the back of the head is mainly innervated by the nerves from the cervical spine, when neck strain, fatigue, cervical spondylosis can cause inflammation, hyperplasia, and misalignment of cervical muscles, fascia, and other soft tissues, these pathological changes will compress the nerves innervating the back of the head, and then the back of the head tightness, discomfort, and even pain. In addition, the blood vessels in the neck can be compressed, resulting in dizziness due to insufficient blood supply to the brain. Therefore, if you have a history of neck strain, fatigue, or strain injury and experience tightness and dizziness in the back of the head, you should first consider cervical spine. In addition, cranial lesions may also cause tightness and dizziness in the back of the head. Therefore, head related examinations can be done, the most common being CT scan and MRI of the head.