Headaches are among the most common health issues people face, but they are not all created equal. Two types that are often confused are occipital neuralgia and tension headaches. While they can share some similarities—especially when it comes to pain in the head and neck—the causes, symptoms, and treatments for each are quite different. Understanding these distinctions can make all the difference in getting the right care and lasting relief.
Occipital neuralgia occurs when the occipital nerves, which run from the top of the spinal cord through the scalp, become irritated or compressed. This irritation can create sharp, shooting, or electric-like pain that often starts at the base of the skull and may radiate toward the forehead, behind the ears, or even behind the eyes. The pain can come on suddenly, sometimes triggered by turning the head, brushing the hair, or other seemingly simple movements. Tenderness in the upper neck and along the scalp is also common, making the condition both painful and disruptive to daily activities.
Tension headaches, on the other hand, are the most common type of headache and usually result from muscle strain, stress, or poor posture. The pain they cause is typically steady, dull, and aching—very different from the sharp, stabbing sensations of occipital neuralgia. People often describe tension headaches as feeling like a tight band wrapping around the head, with discomfort spreading across the forehead, temples, and back of the head. These headaches can last from half an hour to several hours, and while they are rarely debilitating, they can significantly impact concentration, mood, and overall comfort.
One of the most important differences between the two lies in how they present and what triggers them. Occipital neuralgia pain tends to be sudden and concentrated at the base of the skull, often made worse by certain movements. Tension headaches are generally more diffuse, developing gradually and often linked to periods of emotional or physical stress. This difference in pain patterns and triggers is key to making an accurate diagnosis and finding an effective treatment plan.
At My Center for Health, we understand how frustrating and life-disrupting chronic headaches can be. That’s why our team takes a personalized approach to treatment, starting with a comprehensive evaluation to determine whether a patient’s symptoms stem from occipital neuralgia, tension headaches, or another underlying issue entirely. For occipital neuralgia, treatment may focus on relieving pressure on the affected nerves through manual therapy, targeted stretching, and postural adjustments. For tension headaches, strategies often involve reducing muscle tension in the neck and shoulders, correcting workplace ergonomics, and creating stress-management routines to prevent recurrence.
We also incorporate complementary therapies such as massage therapy or chiropractic adjustments when appropriate. These approaches can work alongside exercise-based rehabilitation to restore mobility, improve muscle balance, and decrease the frequency and severity of headaches. Our goal is always to address the root cause of the pain rather than simply masking the symptoms.
If headaches are a frequent part of your life—especially if they are becoming more intense, more frequent, or resistant to over-the-counter remedies—it’s important to seek professional help. Early diagnosis and targeted care can prevent chronic pain from taking hold and allow you to return to daily life without constant discomfort.
At My Center for Health, we believe you shouldn’t have to live with the uncertainty of wondering what’s causing your pain. With the right evaluation and treatment, relief is possible—and it starts with understanding the difference between conditions like occipital neuralgia and tension headaches.
