Sub-occipital headaches – what are they and how can they be treated?

Neck pain at work

For most of us, our first response to a headache is to reach for the painkillers or possibly swear off drinking.

A common assumption is that headaches come from inside our head, but in clinic we often treat cervicogenic headaches. We have touched on these before, but today want to focus on a particularly common type – sub-occipital headaches.

What are they?

The occiput, in simple terms, is the back of the head. The sub-occipital muscles are the muscles that insert in the occiput.

These muscles can become tight, which can lead to headaches at the back of the head and even refer to the front, across the forehead.

No headaches are pleasant, but the good news is these are easy to get rid of doing some soft tissue techniques such as this.


30-60 seconds each side once a day should be enough to see a notable improvement within a matter of days, although just be aware it will be a little uncomfortable. If it’s very sensitive we also wouldn’t recommend doing it much more than this as, whilst it can still be effective, it can also bring on headaches for a couple of days afterwards.

What causes it?

Neck pain at workThe muscles tend to become overworked/hypertonic if they are doing more than they are currently conditioned to do. A good example of this may be sitting at a computer for 8-10 hours per day.

In this example the small postural muscles can start to fatigue and the head begins to drop. To avoid this we bend the head back slightly and holding this position for a long time (e.g. when at your desk or on a long bike ride), can lead to the muscles tightening up and the referring to the head.

How to stop it happening again

One simple thing is Pilates. When taught and practised correctly, it can enable you to use your postural muscles automatically as well as building up their strength and endurance meaning you don’t use your big, superficial muscles too much so they don’t became tight and hypertonic.

If you find cycling can bring this on, there’s a good chance you’ll also find it helps to improve your position on the bike and get a rock solid posture like Sir Brad in his pomp.

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