Among many other pains in your body, one is common, which starts from the shoulder and neck and then spreads to the base of the skull. It might cause pain in back of head at back of skull.  But why? and how to get over it?

Commonly, neck pain is the main issue in the US, and the research shows that almost 5.9% of women and 4% of men experience neck pain in the US. As a result, this pain moves to the skull base, which needs treatment.

If you are feeling Pain in the back of the head at the base of the skull and neck a physical therapist can help because he can diagnose the pain in the back of the head at the base of the skull and make a better treatment plan for this.

 Occipital Neuralgia vs. Other Headaches 

Pain in Back of Head at Base of Skull

Occipital neuralgia is not like other types of headaches because of:

  • Cause
  • Area of pain
  • Types of pain

Commonly, injury to occipital neuralgia (the greater, the lesser and the third) leads to occipital pain. Sometime it cause pain in back of head at base of skull right side. These occipital nerves start from the spine to the scalp and then spread to both sides of the head. So, at any point in this pathway, injury or irritation may occur.

Some causes of headache are:

  • Tension
  • Sinus infection
  • High blood pressure
  • Use of certain medications
  • Migraine

Some searches have been done which showed that pain in back of head at base of skull is the role player in neck pain. So if a person notes head and neck pain for 15-20 days in a month, then he must consult the doctor.

 Main Symptoms to Consider 

Occipital neuralgia pain is a serious issue that can cause shooting, throbbing and shock. Commonly, this pain lasts for a few to several minutes and continues between the spasms. The pain commonly starts from the neck and spreads to the skull base and affects:

  • Top of the neck
  • Behind the ears
  • One side of the head
  • Back of the head
  • Behind the eye
  • Area of scalp

You may also feel:

  • Sensitivity to light and touch
  • Soreness
  • Bursting of pain
  • Aching

There are some movements that may worsen the pain, such as:

  • Turning of your head to one side
  • Washing or brushing your hair
  • Laying your head on the pillow

The pain in the back of the head at the base of the skull may be severe, and some people feel it like a migraine, so it requires different types of treatments.

 Causes of Pain in Back of Head at Base of Skull 

Pain in Back of Head at Base of Skull

Some types of headaches are caused by the pain in the skull base, which is because of tension, overuse of medicines and migraines. Some common causes of this pain are:

  • Tension headaches
  • Migraine
  • Headache due to overuse of medicines
  • Occipital neuralgia
  • Exercise headaches

 1-Tension headache 

Tension is the main cause of tightness of the forehead, which can also affect the neck, shoulders and scalp and cause discomfort. Commonly, the duration of this headache is 7 days, but the lasting time is almost 30 minutes. The following are some symptoms of this pain:

  • Feel tightens around the head, including the head back, neck and face
  • Feeling of mild to moderate pain which may occasionally become severe
  • No symptoms of nausea and vomiting
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These are common types of headaches that may often start at an early age and increase in severity with increasing age. It bring Nerve pain in the back of the head at the base of the skull. In adult age, migraine may occur several times in a week and is common in women ages between 35-45 years.

The following are some symptoms of migraine:

  • Throbbing or severe pain on one side of your head
  • Nausea
  • Vomiting
  • Visual disruption
  • Sensitivity to smell, light and sound
  • Intense physical activity
  • Muscles soreness

 3-Cervicogenic headache 

This pain commonly occurs in the neck and spreads to the head. Commonly, it is caused by itching in the cervical nerves. The following are some symptoms of cervicogenic headache:

  • Visual issues and pain around the eyes
  • Neck, shoulders and arm pain
  • Head pain when you move
  • Nausea
  • Light and sound sensitivity

 4-Occipital neuralgia 

It is a common headache type that commonly affects the head and back and is related to the damage of occipital nerves, which may run from the neck back to the scalp base. Some common causes of pain in the back of the head at the base of the skull and damage include neck tension and unknown factors.

The following are some symptoms of this condition:

  • Throbbing and burning
  • Shocking and shooting
  • Tenderness
  • Sensitivity to light and sound

When you notice any of these symptoms, then make sure to consult the doctor. Though this pain may be confused with other headaches you can distinguish it by applying more pressure on the head back.

 5-Exercise-induced headache 

This headache may occur due to physical activities, which may suddenly start after intense exercise. The pain may be triggered due to some exercises such as weightlifting, running, sexual intercourse and more. The symptoms of this headache include active pain on the head sides, which may remain for a few minutes to 2 days and may often cause migraine-like symptoms.

 6-Cluster headache 

This headache is severe pain in a specific part of the head and around the eyes. However, the headache causes discomfort and burning and may remain for 20 minutes to a few hours. The cluster period of cluster headache is around days, weeks and months. The following are some symptoms of this headache:

  • Restlessness
  • Soreness and puffiness around the eyes
  • Nasal mobbing
  • Congested nose
  • Pale skin
  • Facial dreading
  • Sagging eyelids

 7-Medication-overuse or rebound headache 

This pain may often occur due to the overuse of medicines for pain relief. Another name for this headache is rebound headache. Though occasional medicine use doesn’t cause any issues when you take a medicine for a long period, which may be 10-15 days, then it may cause the occurrence of rebound pain.

The following are some symptoms of this pain:

  • Consistency and daily headache
  • Become worse while waking
  • Feel pain after stopping using the medicine

Some other issues that may be linked to this headache include:

  • Tiredness
  • Sickness
  • Nervousness
  • Prickliness
  • Lack of energy
  • Physical weakness
  • Agitation
  • Difficulty in concentration
  • Depression

 8-Low-pressure headache 

Another name for this headache is positional headache which is associated with the pain in the head back and is caused by intracranial hypotension. This condition is when the cerebral fluid pressure decreases to 60 mm of water. Some time you may feel sharp pain in the back of the head at the base of the skull.

Commonly, you feel intense headaches while sitting and standing but feel better while lying down. Some other causes of triggering this pain include sneezing, straining, bending and coughing. Commonly, people wake up with a better headache level, but it may worsen with the going day. But eventually, the pain goes and becomes weaker. But, this headache affects the head back and front area and sides of the head. Some symptoms of this pain include throbbing, aching and stabbing.

 When & How to Seek Medical Care? 

Though occipital neuralgia is a common issue most of the time, it can be confused with migraine because of similar symptoms. If you feel Pain in the back of the head at the base of the skull treatment you must consult the doctor when you feel some uncommon symptoms or sharp pain in your neck or scalp back. Also, when you don’t feel sensitivity to light and nausea, then it is good to seek medical help. Otherwise, the problem becomes worse.

Pain in Back of Head at Base of Skull

 Testing & Diagnosis 

Though diagnosing occipital neuralgia is a trickier task because of no specific test that may reveal the positive or negative results. Commonly, doctors physically and neurologically examine to know any abnormalities. If the doctor is unable to make the right decision after examination, then he conducts further imaging to figure out the cause of pain.

Commonly, doctors prefer MRI or magnetic resonance imaging tests, which provide three-dimensional imaging of body structure and reveal any issue. Another method is a CT scan, which creates imaging of body structure. On the other hand, most doctors use occipital nerve blocks to diagnose the issue.

 How Can Physical Therapy Treat the Pain in Your Occipital Region? 

Physical therapists are not only able to identify the cause of pain in the back of the head at the base of the skull. But they can also diagnose and treat many other pain. The therapist uses knowledge of the human musculoskeletal system to create a better treatment plan. Commonly, the treatment plan includes:

  • Myofascial release
  • Aquatic therapy
  • Soft tissue mobilization
  • Therapeutic exercises
  • Ergonomic training
  • Instrument-assisted soft tissue mobilization (IASTM)
  • Dry needling


There are some types of exercises that may treat occipital neuralgia when bad posture becomes the cause of this issue. Chin tucks are the best exercise to stretch and strengthen the neck muscles and other tissues. To perform this exercise, you have to:

  • Stand against the wall with the feet shoulder apart
  • Keep the chin down and pull the back of your head until it touches to the wall
  • Stand in this posture for almost 5 seconds

When you pull the back of your head, make sure to keep your chin in a straight position and avoid tipping.

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 Home Remedies 

If you feel pain in the back of the head at the base of the skull on the left side you have to try home remedies. Some home remedies that may treat occipital neuralgia include:

  • Rest
  • Massage of the skull using fingertips
  • Application of warm compresses for 15 minutes
  • Exercise such as chin tucks

Make sure to consult the physical therapist and find the treatment plan to manage pain and avoid recurrence.

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There are many options to avoid occipital neuralgia. These may be tricyclic antidepressants and anti-seizure medications.

The following are some preventive measures to avoid occipital neuralgia:

  • Use better body posture
  • Never keep your head in the down position for a long duration
  • Exercise regularly such as yoga


Though headache is a common pain it may affect the quality of life and interfere with everyday activities.

Some headaches may go without any proper treatment, while some may become serious. So, anyone suffering from pain in the skull base must consult the doctor. A doctor will diagnose any underlying cause of pain in the back of the head at the base of the skull and will recommend the right treatment.

Occipital neuralgia is the main type of nerve pain that may become the cause of headaches. Commonly, this pain starts because of damaged occipital nerves and starts from the neck to the head. In some cases, home remedies are effective in alleviating pain, while in some cases, surgery is necessary.

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Frequently Asked Questions:

What causes pain in the back of the head at the base of the skull?

Occipital neuralgia is the major issue, which may be due to tight muscles and pinched nerves of the neck. Another reason for this issue is head and neck injury. There are two types of this issue, which are primary and secondary.

What illness causes pain at the base of the skull?

Occipital neuralgia is a rare condition that causes burning, shocking, throbbing, aching pain and headache, which commonly start at the head base and then spread to the entire head.

Should I worry about pain in the back of my head?

When you notice new and unusual symptoms, then it is time to consult the doctor. However, when you feel sudden and severe pain then it may be life-threatening.

Is back of head pain normal?

Commonly, pain in the back of the head at the base of the skull is due to tension, which is not a sign of any serious disease. There are many factors for headaches that allow you to prevent all such factors to avoid pain.

Can stress cause pain at the base of the skull?

This pain commonly starts from the neck and shoulders and then spreads to the base of the skull. The pain is caused by many reasons such as eyestrain, bad posture and stress.

Is occipital neuralgia serious?

Occipital neuralgia is not a serious issue and can be cured through rest and medicines. But if you feel the pain intense, then consult the doctor.

What is the fastest way to cure occipital neuralgia?

There are many fast ways to cure this pain. These include massage, stretching, hot and ice therapy. If you don’t notice any relief from this treatment, then you have to go for a spinal cord stimulator.