Pain At The Base of Skull

Headaches can happen for a variety of reasons. The intensity and severity of headache may vary too; from mild, moderate, to severe headache. More so, a headache can occur in any parts of the head. For pain at the base of the skull or back of the head, the underlying cause could be vast. So, a thorough examination and investigation need to be done to identify the root cause and come up with the appropriate course of action.

(Throbbing pain at the base of the skull can be caused by a damaged nerve that runs from the spinal cord to the skull.) (Throbbing pain at the base of the skull can be caused by a damaged nerve that runs from the spinal cord to the skull.)

What does a headache in the back of the head indicate/what causes pain at the base of the neck?

  • Arthritis headache – The term arthritis does not always denote inflammation of the joints. It can also denote pain in the head. Arthritis headache is usually a cause of swelling in the area of the neck. The pain is not only felt in the neck but as well in the back of the head. The pain gets intense with movement.
  • Poor posture – Don’t you know that a poor posture can cause pain at the base of the skull. Poor posture causes tension not only in the back but also in the shoulders and up to the neck. The typical characteristic of pain is dull and throbbing in nature.
  • Herniated disc – A herniated disc of the spine causes pain and tension in the neck leading to a cervicogenic headache. The pain is prominent in the back of the head just at the base of the skull. The pain can also radiate to the temples and the areas behind the eyes.
  • Occipital neuralgia – It is characterized by a sharp, throbbing, and aching pain that begins at the base of the skull and moves towards the neck and scalp. The reason behind the pain is that the nerves that run from the spinal cord to the scalp get damaged. It is oftentimes mistaken to migraine. You know that it is occipital neuralgia when other symptoms become prominent such as pain behind the eyes, sensitivity to light, painful scalp, pain when moving the neck, and sharp stabbing pain that feels like you have been hit by an electric shock. (1, 2, 3, 4, and 5)

The following conditions can be linked to occipital neuralgia:

  • Osteoarthritis
  • Tension in the neck or trauma to the back of the head
  • Cervical disc-related diseases
  • Neck tumor
  • Diabetes
  • Gout
  • Infection
  • Inflammation of the blood vessels (4, 5)


The patient’s past medical and surgical history will be investigated, especially injuries in the head, neck, and the rest of the cervical spine. A thorough physical examination should be done too such a gently pressing the areas at the back of the head. Aside from history taking and physical examination, the doctor might also give you a shot to numb the nerve (nerve block) and watch out for any signs of relief. If the pain is relieved following a nerve block, then most likely you are suffering from occipital neuralgia. In some instances, the doctor will order additional imaging studies such as an MRI scan. Accurate diagnosis is a must so that the patient will be able to get the appropriate treatment. (5, 6, and 7)

Is occipital neuralgia life threatening?

Occipital neuralgia is not a life-threatening condition. In fact, with timely and appropriate treatment, the patient will be able to improve significantly.

Is pain at the base of the skull related to brain aneurysm?

Pain at the base of the skull can be linked to brain aneurysm as a cerebral aneurysm can affect many parts of the brain. Although, for the most part, it affects the arteries along the base of the skull. Small brain aneurysm usually goes undetected until problems get worse. (4, 6, and 8)

Are there warning signs of a brain aneurysm?

  • Stiff neck
  • Extreme headache that occurs sudden
  • Nausea and vomiting
  • Sensitivity to light
  • Blurring of vision
  • Seizure
  • Confusion
  • Drooping of eyelids
  • Loss of consciousness (7, 8)
(The patient can benefit from a chiropractic adjustment.)

How do you relieve pain in the back of your head?

Relieving pain in the back of the head can be done using simple home remedies such as:

  • Apply heat compress to the base of the skull.
  • Stay away from the noisy environment.
  • Gently massage the base of the neck.
  • For pain relief, you should take over the counter pain reliever. If the pain does not subside with over the counter medication, then you need a strong medicine such as the ones prescribed by your doctor. (3, 4, and 5)
  • The patient will also receive nerve blocks and steroid shots, but these are short-term treatments and are designed to help in the diagnosis.
  • Microvascular decompression can be given to the patient so as to alleviate the pain. This procedure includes finding and adjusting the blood vessels that are responsible for compressing your nerve.
  • For occipital neuralgia, the patient will receive a nerve stimulation through the use of a special device called neurostimulator. The device delivers electrical pulses to the occipital nerves so as to block the pain pathway.
  • For pain at the base of skull secondary to a herniated disc, the patient can benefit from chiropractic manipulation, physical therapy, and gentle stretching. Surgery can be done too, but it should always be the last resort. (8, 9, and 10)

When should you see your doctor?

The patient should see her/his doctor if she/he experience the following:

  • The patient suffers from new headaches that last for several days.
  • The headache gets severe to the point that it interferes with your activities of daily living.
  • If your headache is accompanied by mood swings and agitation.
  • If aside from headache, you experience confusion, fever, and inability to focus.
  • If your headache is accompanied by slurring of speech, visual disturbances, facial weakness especially on one side of the face, and numbness of the body. (1, 4, 7, and 10)

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