Skull Base Hurts: Causes and Treatments

Skull base ache may indicate problem with joints, ligaments, nerves or muscles in this area. Find the most common causes and what you can do here.

The sub-occipital region, located between the base of your skull and the upper cervical spine, is rich in nerve fibers, small muscles, and joints. These joints, muscles, and nerves can generate pain, which is the reason why it is not easy to identify the reason why you feel pain at this area. Keep reading to learn about some of the most common causes of pain in the occipital region.

What Causes Pain at Base of Skull?

First please know that if the pain is severe and persists, the best way to determine the real cause of concern is to consult a neurologist, who will consider your medical history as well as symptoms to make a diagnosis. They may also order imaging studies and refer you to other specialists based on the findings in your tests. Below are some common causes:

1.   Tension Headaches

Certain headache subtypes may cause pain at the base of the skull. This usually happens due to tension headaches that usually produce mild to moderate levels of diffuse pain. The pain maintains a band-like pattern and often travels to the base of the neck.

How to get relief: Rest, ice, or a hot shower may relieve tension and help you get rid of your headache. Maintaining correct posture and taking steps to manage stress will also help prevent tension headaches.

2.   Occipital Neuralgia

This neurological condition is characterized by the inflammation of the occipital nerves. Many patients of occipital neuralgia think what they have is a migraine attack.

Symptoms are quite similar, but occipital neuralgia can cause excruciating pain that feels like a jabbing electric shock in the back of the neck and head. Other symptoms include pain behind the eye, pain on sides of the head, tender scalp, sensitivity to light, and pain when moving the neck.

How to get relief: To find an appropriate treatment, it is important to identify what is irritating the nerves. Here are some ways to relieve pain at base of skull:

  • Try a heat pack and apply it directly to the neck
  • Take some rest in a quiet room
  • Get a massage to reduce tightness in your neck muscles
  • Take OTC anti-inflammatory drugs, such as ibuprofen or naproxen.

When these self-care measures do not work, you may want to take certain medications. You can try prescription muscle relaxants or use antidepressants. Anticonvulsant drugs such as Neurontin or Tegretol may also help. Short-term use of steroid injections or local nerve blockers may also help relieve pain and inflammation.

3.   Upper Neck Injury or Strain

When the muscles, ligaments, tendons, nerves, or joints of the upper neck sustain an injury, you may experience severe pain at this area. For example, your neck joints can cause neck type headache when they are locked in a wrong joint position for long. If your shoulder blade and neck muscles are knotted, overworking or in spasm, they’ll send a pain signal to your brain. Similarly, some neck muscles work heavily to protect injured neck joints, but this makes other muscles to become weak due to a lack of work. This may also generate pain at the base of your skull.

In this condition, you need to be checked by your doctor for proper treatment. 

4.   Diseases and Tumors

You may experience pain in this region if you are suffering from certain diseases, such as arthritis. It may also happen due to brain abscesses that develop in the occipital area of the skull. Paget's disease may also result in pain because it leads to bone destruction in the area. Other common diseases that may cause pain at base of skull are spinal meningitis, brain tumors, and brain aneurysms. Both viral and bacterial meningitis may cause headaches with stuff neck – you may also experience nausea, fever, and sensitivity to light. In addition to these conditions, some people experience pain in this region due to a tumor. The tumor is usually benign and can develop in the back, middle, or front part of the skull.

5.   Meningeal Compression and Fibromyalgia  

Meningeal Compression (MC) refers to an encroachment on the covering of the brain and spinal cord. This may produce fibromyalgia symptoms with severe pressure at the base of the skull. Fibromyalgia causes widespread pain as well as fatigue and fibro fog (inability to focus or concentrate).

Tips to Deal with The Pain 

You should remember a few tips to treat your pain more effectively. For instance:

  • Change your posture if that is causing any problem. Make sure your computer monitor is in an elevated position to keep your head from tilting. This will reduce strain on the occipital muscles.
  • Do not slouch. Try Pilates, yoga, or Tai Chi to improve your muscle strength and posture. Consult with a chiropractor, physical therapist, or movement therapist for exercises to improve your posture and muscle strength.
  • Apply a warm pack at the base of the head for 20 minutes to reduce inflammation and pain.

Medicines to Help

When you have pain at base of skull, you can always take some specific medicines to improve your condition. NEVER intend to use medications without seeking medical advice. For instance:

  • Paracetamol: Adults should take 2 tablets of 500mg four times a day for pain relief.
  • Anti-inflammatory painkillers: You may take these painkillers if paracetamol does not offer any help. You can take ibuprofen or prescription painkillers, such as naproxen or diclofenac to relieve pain. You may avoid using prescription anti-inflammatory painkillers if you have asthma, stomach ulcers, or heart and kidney problems.
  • A stronger painkiller: When OTC painkillers do not produce desired results, you may want to try a stronger painkiller such as codeine. You can take it along with paracetamol. Keep in mind that codeine is not for everyone and may cause constipation in some patients. Be sure to drink plenty of water and eat fiber to prevent constipation.
  • Muscle relaxants: You can take a muscle relaxant, such as diazepam for a few days to make your neck pain manageable.

When to Worry

It is important to talk to your doctor to confirm your neck pain is not due to some serious issue. You should see your doctor immediately if you experience the following symptoms:

  • You experience neck pain and you already have cancer, AIDS, or rheumatoid arthritis
  • Your pain becomes worse with time
  • You find it difficult to move your arm properly and feel weakness in muscles
  • You have a feeling of being unwell and lose weight quickly
  • You have tender neck bones that represent a bone problem
  • You have difficulty passing urine or walking


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