Suboccipital Headaches: Discover the Causes and Solutions

Suboccipital headaches can really disrupt your life.

If your suboccipital muscles go into spasms, they can entrap the nerves that travel through the suboccipital region.

Discover how to relax and release the suboccipital muscle and find relief in our new blog.

What is a Suboccipital Headache?

The base of the skull is a superhighway of nerves, muscles, ligaments, joints, and bone (1).

The ligaments and muscles in that area have the main job of keeping our heads attached to our necks properly—basically, they keep our head on straight.

An important nerve in the area is called the occipital nerve, which runs from our second and third vertebra of the neck and along the back of our scalp on both sides of the head.

The Doubling Your Patient Retention with Email Guide from The Smart Chiropractor

The Smart Chiropractor's Guide to Doubling Your Patient Retention with Email

Click Here to Download

Some of the most easily irritated muscles in that area are located in a group called the “suboccipital triangle.”

What Causes Suboccipital Headaches?

In response to physical or emotional stress, like a forward-leaning head posture, whiplash accident, or stress and anxiety, the area of the base of the skull can become sensitive and inflamed.

That inflammation puts stress on the nerves and joints, which can result in painful headaches (2).

Did You Know

The World Health Organization estimates that 50% of adults worldwide suffer from recurring headaches, which is why providers need to be prepared for these cases!

Though there are many types of headaches (some estimates list up to 150 different varieties and causes), the primary types are migraine, tension-type, and cluster.

Headaches are among the most common nervous system disorders, yet healthcare providers struggle to accurately diagnose specific types.

Headaches remain underestimated, under-recognized, and under-treated across the globe.

"The Smart Chiropractor has helped me stay constantly booked. No bait and switch discounts that make you look worse than a used car salesman."


Dr. Sam Liveriadis, DC

North Road Chiropractic

Automate Your Emails

The good news is that with more emphasis on health and wellness, research is focused more than ever on narrowing down pinpoint diagnosis methods and effective treatments for headaches!

An evidence-informed clinician should do a thorough exam to identify the cause of the headache.

The causes of a suboccipital headache can range from allergies and postural issues to emergencies such as an aneurysm, and it is important to take every detail possible for a proper diagnosis.

Get This

Great news – Chiropractors are expertly trained to evaluate and diagnose headaches (3)!

Chiropractors will ask many questions about the history of the headaches, level of pain, area of concern, and lifestyle factors to ensure that no stone is left unturned.

Two factors in particular will lead the clinician to the diagnosis of a suboccipital headache: tight muscles at the base of the skull and a significant loss of curve of the neck.

Harvard Health Publishing notes that poor posture can result from overly tight muscles (4).

Does loss of the neck curve happen because of tight muscles, or do the muscles tighten to create stability with forward-leaning head posture?

Male Chiropractor Evaluating Cervical Spine of Young White Male Patient Reporting Frequent Suboccipital Headaches
Suboccipital Headaches: Causes

It might just be a question of the chicken or the egg, whichever came first!

Test the muscles, ligaments, joints, and nerves and palpate the areas to begin developing a diagnosis.

Suboccipital headaches are one among many headaches that we can get as human beings, but what sets them apart is their location and severity.

Know This

Because of the specific location at the base of the skull, the symptoms can range from a dull throb to a painful, zapping tingle along the scalp.

The difference between annoying discomfort and a painful day in bed?

Nerve involvement.

If the symptoms for this headache are not severe, the headache is most likely linked to inflamed muscles, ligaments, and joints in the area.

Experiencing piercing pain with zinging or tingling?

There might be inflammation affecting the nerves in the area, specifically the occipital nerve.

Mature Male Patient Reporting Tingling Pain with His Suboccipital Headaches to Young Latino Female Chiropractor
Suboccipital Headaches: Occipital Neuralgia

When this nerve is involved, the condition can be referred to as “Occipital Neuralgia” (5) and might require more serious attention.

Diagnosis methods for suboccipital headaches can vary.

If the headaches started after a traumatic accident, an x-ray or MRI of the area would be a good way to diagnose the cause of the issue.

However, without that type of physical cause, these imaging procedures are mainly used to rule out other possible diagnoses.

Can Chiropractic Help Suboccipital Headaches?

Once the doctor concludes that the cause of the problems is a suboccipital headache, the work can begin!

Coupled with a thorough physical examination, a chiropractor will be able to put together a helpful treatment plan.


Chiropractic treatment for suboccipital headaches has been proven to be effective in reducing and removing symptoms (6).

Spinal manipulation, along with specific work on the muscles at the base of the neck, can help reduce the pain and symptoms of chronic and acute neck pain leading to headaches.

When poor posture is one of the causes of suboccipital headaches, using a technique such as the Pettibon System will work to correct the curve of the neck (7).

Male Chiropractor Evaluating Posture of Young Asian Female Patient Alongside Spine Model
Suboccipital Headaches: Posture

Neck curvature can flatten over time, especially with those working from home or on the computer for most of the day.

Though this loss of curve is mostly asymptomatic, the strain on the muscles and ligaments surrounding the neck can contribute to unpleasant headache symptoms.

The chiropractor might also teach specific stretches or exercises to relieve pain along the neck.

These self-guided muscle movements can enhance the healing process when combined with treatment appointments.

How Do You Relax the Suboccipital Muscles?

Other chiropractic modalities can provide relief for suboccipital headaches as well!

Dry needling (8) is a technique that inserts several fine needles into the skin, focusing on relaxing the suboccipital muscle and reducing muscle spasms.

Heat is also an effective way to relax the suboccipital muscles in the area when used as directed by your provider.

Female Massage Therapist Working Male Patient's Neck to Help Relax the Tight Neck Muscles Contributing to His Suboccipital Headaches
Suboccipital Headaches: Relaxation Techniques

The chiropractor may utilize other techniques not listed here to treat the condition or work to address any lifestyle factors contributing to headaches.

These factors can include poor ergonomics, not drinking enough water, tension in the jaw, unhealthy nutrition habits, smoking, etc.


Suboccipital headaches can be caused by more severe underlying nerve issues, which is why chiropractic treatment may not be enough to ultimately reduce symptoms.

Occipital Neuralgia is an inflammation of the occipital nerve and can be challenging to treat.

The occipital nerve is situated at the base of the skull and travels up both sides to the ears.

The inflammation can cause more severe headaches and can be more difficult to treat when the source of the pain is internal (9).

Oral medication, botox injections, and nerve blocks are all treatments that have been shown to lower the severity of the symptoms.

Male Chiropractor Checking in with Patient While Performing a Spinal Adjustment to Determine Next Steps for Treating Patient's Suboccipital Headaches
Suboccipital Headaches: Treatment Options

If all other treatments fail to help or only provide short-term relief, there are surgical options available.

A relatively new nerve decompression surgery (10) offered longer-lasting relief from suboccipital headaches with occipital nerve involvement.

Recovery time for this surgery can take one to two weeks, and several studies have shown relief of up to 90% for around six years after surgery was performed.

Talking to doctors about treatment should include discussing all possible options.

Know This

Current clinical guidelines (11) recommend a multidisciplinary approach to treatments for moderate to severe headaches, resulting in an array of conservative pain management options before considering more serious surgical routes.

Why Do You Get Suboccipital Headaches?

Now that we understand what a suboccipital headache can look like, how to diagnose it, and treatment options—the “why” comes into play.

Headaches are estimated to cause up to 20% of work absences in America, yet differentiating between the types of headaches remains a challenge.

Chiropractors Know

Standard physical examinations and imaging procedures often aren’t enough to narrow down the specific headache types, which is why a thorough history is needed when a patient presents with headaches.

If an underlying cause for the headaches is determined, a focused treatment effort can be placed on addressing the source of the problem!

The National Institute of Neurological Disorders and Stroke recommends preventative care (12) for tension-type headaches, including “alternative” therapies such as spinal manipulation accompanied by prescription oral anti-inflammatory medication administered by a primary care provider.

Young Latina Chiropractor Smiling While Explaining the Causes of Suboccipital Headaches Using a Lifesize Spine Model
Suboccipital Headaches: Chiropractic Care

Chiropractors are incredibly valuable members of the team for patients with headache disorders.

Our training in diagnostic evaluation combined with a wide array of treatment options can be the master key that unlocks the door!

A Word About Patient Pilot by The Smart Chiropractor

Are you a chiropractor or chiropractic para professional?

Thanks for reading!

We hope this article has given you some great notes to share with your patients so you can create videos and more great content that covers how you can help your community find relief from their suboccipital headaches.

Our team at The Smart Chiropractor is dedicated to making patient communication easier for DCs and their staff through free resources like our blog and our subscription-based patient-education-focused marketing materials and services.

That’s where Patient Pilot comes in.

A Showcase of the Different Features Offered to Members of Patient Pilot by The Smart Chiropractor
Chiropractic Email Marketing Best Practices: Patient Pilot

Our automated email campaigns were designed to help provide patients with a fantastic experience that, in turn, can help fill the holes in your practice’s patient bucket and generates excellent ROI.

Over the past year, our team of chiropractic marketing geeks at The Smart Chiropractor has worked with over 300 practices and sent over 10 million emails – and those include email campaigns about how to find relief from suboccipital headaches.

(And we’re thrilled that our average doctor has seen an 11X ROI from their email marketing efforts!)

There’s one BIG thing we learned from working with practice after practice after practice that we’ve kept in mind as we crafted our recent top 10 list of chiropractic email marketing best practices and our email systems…

Too many chiropractors with holes in their schedule form their marketing strategy around the notion that they have a new patient problem.

However, that’s often NOT the case.

Think of it this way…

Know This

When you have holes in your patient bucket, and the faster you dump new patients (water) in the top of the bucket, the quicker it will pour out the sides (retention) and bottom (reactivations) until you seal the holes.

If you have an email list of over 300 patients – that’s 300 local patients that have walked through your doors and experienced your care firsthand – it’s not true.

With a list of that size, what you almost certainly do have is a patient retention and reactivation problem.

Click here to schedule a demo and see how our Patient Pilot email system and automated email campaigns can transform email marketing in your practice.

Click to View Science Sources

Patient Pilot is Here!

Send Emails. Reactivate Your Patients.

Send this to a friend