Posterior Head and Neck Pain

Head and Neck Pain  | Baltimore Nerve Decompression Surgeon

Head and neck pain is a common problem faced by millions of men and women in our country (and all over the world). The causes and severity of pain in the head and neck regions can vary drastically. In some cases, the pain is simply an annoyance. At other times, it can be downright debilitating.

Our office specializes in neurologic issues relating to the peripheral nerves throughout the body. One area of special interest is when pain is caused by occipital nerves. If you are suffering from moderate to severe posterior head or neck nerve pain (not coming from spinal cord issues), we may be able to help.

This blog post might give you an idea as to what is possibly happening, but please keep in mind it is not a substitute for receiving a professional diagnosis obtained by reviewing medical records, medical history, and conducting a physical exam. Doing so can give you a better idea as to what is actually going on and what may be needed to address it. Our hope with this post is to give you more information which may help guide decisions made with your medical team.

It is important that patients are first ruled out for life-threatening problems before coming to our office. You might need to see a spine specialist or pain management specialist.

Common Causes of Head and Neck Pain

From a very general overview, head and neck pain are sometimes caused by physical tension, hormones, sinus issues, tooth infections, jaw joint issues, hypertension, illnesses, and pinched nerves.

Obviously, that is a wide range of potential root causes. If your head and/or neck pain is the result of anything not related to your peripheral nerves, you may want to start with a visit to your primary care physician. This is a good starting point for determining why you are experiencing the pain. In the event it is determined to be nerve-related and you have not found relief elsewhere, come see us for a consultation.

Two potential nerve-based sources of head and neck pain are occipital neuralgia and peripheral nerve compression.


Occipital Neuralgia

One of the most common sources of posterior head and neck pain is occipital neuralgia – a condition that occurs because of peripheral nerve compression. We see this condition in two major groups of individuals who experience whiplash – sports-related concussions and auto accidents.

Occipital neuralgia is a condition wherein the nerves running from the spinal cord to the scalp are damaged, stretched, compressed, or otherwise injured. We currently believe occipital nerves in the neck after stretch traction injury or have become bruised and damaged can result in swelling and compression.

This is often confused with migraines (which highlights the importance of having a professional diagnosis!). Occipital neuralgia causes sharp, aching, throbbing pain that usually starts at the base of the head in the neck and moves forward towards the forehead. With posterior occipital neuralgia, the pain radiates up the back of your skull.

For some post-trauma patients, head and neck pain changes with the weather or becomes more severe with increased barometric pressure. Also, exercise can lead to issues when blood pressure is elevated or you are moving your head and neck (especially with repeated actions and activities). Further, looking down may be painful.

Your pain may also be caused by issues with peripheral nerves in back of neck.

Your body relies on a vast network of peripheral nerves to communicate with your central nervous system (the brain and spinal cord). Due to various potential issues, sometimes these nerves become compressed (pinched). When this happens, the nerves do not perform as intended, and this can cause many kinds of painful sensations.


Some patients may need nerves to be surgically released from structures across the neck – like small muscles, blood vessels, and scar tissue. (One can think of this as being like tarsal tunnels syndrome for the back of the head.)

We should not be your first stop for this particular issue. Affected individuals generally have a good chance to resolve when condition is caught early and seen by a neurologist Kevin Crutchfield, M.D., at Sinai. However, if aggressive nonsurgical does not provide the relief you need, surgical management could be the answer you are seeking.

If you are unable to find relief from posterior head and neck pain through other treatment options—medication, physical therapy, etc.—there’s a chance peripheral nerve surgery is the appropriate course of action.

When you come see us, we will not automatically recommend surgical intervention. Instead, we take the time to listen to you, carefully evaluate your situation, and then decide whether we might have the right techniques to help. If we determine you would be better served by seeing a different kind of medical specialist, we will say as much. But if we think we may be able to help, we will let you know that as well.

For more information on head and neck pain—or to request your consultation—give us a call at (410) 709-3868.

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.
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