The occipital nerves run from the top of the spinal cord through the scalp. They innervate the posterior scalp, ears, and other structures in the head. Occipital neuralgia is a rare chronic headache disorder that arises from problems with these nerves.
Occipital neuralgia feels different from regular headaches and migraines. Rather than the persistent dull throbbing or pounding associated with most headache disorders, the pain is often described as a severe piercing, stabbing, or sharp sensation. The pain usually concentrates in the back of the head, upper neck, or behind the ears. The onset of the pain is also more sudden and quick compared to migraines. It can be triggered by actions as minimal as slightly touching or brushing your hair. 
Unlike migraines which can last for hours, the worst part of occipital neuralgia headache lasts only a few minutes or seconds, although tenderness around the occipital nerves may continue afterward. Like migraines, however, the pain may affect one side of your head more. They don’t present with migraine symptoms like teary or red eyes though.
The American Migraine Foundation estimates that three out of every 100,000 people are affected by occipital neuralgia every year. This article discusses the factors that cause the development of this chronic condition.
Causes of Occipital Neuralgia
Many conditions can cause occipital neuralgia. What they all have in common is that they affect the occipital nerves. The way this happens may differ. It is most commonly caused by pinched nerves in the root of one’s neck. It may also be caused by muscle tightness in the neck. Head or neck injury is another common cause of occipital neuralgia. In most cases of occipital neuralgia, the precise cause is unknown or attributed to chronic neck tension.
Secondary conditions or underlying diseases may also cause occipital neuralgia. These include: