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"Why does the base of my skull/top of my neck always ache?"

ZocdocAnswersWhy does the base of my skull/top of my neck always ache?


I'm a 23 year old woman and have been experiencing pain right where the base of my skull and the top of my neck meet. The pain is a dull ache, similar to a headache or muscle ache. I feel the pain every day from the time I wake up to the time I go to sleep - it has been occurring for months now. I thought it might have been stress related, but it continues even when stress is reduced, the area is massaged and relaxed, or when medication is taken. I haven't noticed any other symptoms though.


There is a long list of diagnoses associated with pain in the back of the head and neck, which is outside the scope of this discussion. Some possibilities may include certain headache subtypes which may manifest themselves with pain at the base of the skull such as that which you are describing. Generally, these do not last all day. Another option is an irritation of the nerve that runs along the back of the skull called occipital neuralgia. This is a common condition that can be seen, in which the nerve develops severe irritation which can be radiating or burning in nature. There are a variety of treatments for this including steroid injections, and various medications that stabilize the irritated nerve so that it does not send out the pain signals to the brain. If these do not work, there are peripheral nerve stimulators that can be implanted to override the pain signals and decrease the pain that you feel. Of course, the only appropriate way to be evaluated would be by a neurologist, who can evaluate your medical history and presenting symptoms, and decide upon the appropriate work up. They may also be able to refer your to other specialists, order imaging studies, and provide medical treatment options if they are available.

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