Neck Pain at Base of The Skull

If you have pain in the Base of the Skull, it is likely that you have tightness, tension and/or over-activity in the following muscles:

  • Sub-Occipitals
  • Upper Trapezius
  • Splenius Capitis
  • Semispinalis Capitis
  • Sternocleidomastoid

(Note: Please see your doctor if you are not sure if the pain in the base of your skull is coming from the muscles. There are many conditions (eg. Occipital Neuralgia, Brain tumors) that can refer pain to this region.)

symptoms associated with base of skull pain

neck pain at base of skull
  • Headaches
  • Dizziness
  • Tender to touch/Bruised feeling
  • Neck stiffness
  • Feeling of having a “heavy head”
  • Pressure at base of skull
  • Pain behind eyes

How do you relieve pain in the base of your skull?

Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. For more informationMedical disclaimer.


1. Releases

Releasing the tight muscles at the base of the skull will help decrease the amount of tension in the area.


a) Base of Skull Release

release base of skull

Instructions:

  • Lie down on the floor.
  • Place a massage ball at the base of your skull.
  • Apply an appropriate amount of pressure onto the massage ball.
  • Be extra gentle when pressing onto bony areas.
  • Gently rotate your head from side to side to emphasize certain areas of stiffness.
  • Continue for 2-3 minutes on each side.

b) Sub-Occipital Release (Using thumbs)

base of skull self release

Instructions:

  • Place your hands behind your head.
  • Push your thumbs into the Base of the Skull.
  • Perform gentle circles with your thumbs.
  • Continue for 60 seconds.

(Note: Please be careful of your thumbs!)

c) Hair Pull

Instructions:

  • Grab the hair at the base of the skull.
  • Gently pull the hair as to pull the skin.
  • Aim to feel a stretch sensation in the region.
  • Hold for 10 seconds.

2. Stretches

I have listed 7 different stretches which target the base of the skull region. Try them all and persist with the one that gives you the best stretch.


a) Sub-Occipital Stretch

base of skull stretch for neck pain

Instructions:

  • Look slightly downwards.
  • Place one hand at the front of your chin and the other at the back of your head.
  • Apply a firm force to the front of your chin to glide the chin backwards/downwards.
  • Whilst maintaining this pressure, proceed to slowly pull your head in a forwards/downwards direction.
  • Aim to feel a stretch at the base of the skull.
  • Hold for 30 seconds.
  • Repeat 3 times.

b) Back of Neck Stretch

back of neck sub-occipital stretch

Instructions:

  • Gently tuck your chin in.
  • Look down.
  • Place both hands behind your head
  • Whilst keeping the chin tucked in, slowly pull your head downwards.
  • Aim to feel the stretch at the back of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Wall Stretch

base of skull neck stretch against wall

Instructions:

  • Lean your upper back against a wall.
  • Walk your feet away from you.
  • Push your hips forwards.
  • Gently tuck your chin in.
  • Nod your chin downwards.
  • Completely flatten the back of your neck onto the wall.
  • Aim to feel a stretch at the back of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.
  • Note: Perform small rotations with your head to target specific areas of your neck.

d) Floor Stretch

pain at base of neck stretch on floor

Instructions:

  • Lie down with your back on the floor and knees in a bent position.
  • Lift your hips high so that the back of your shoulders, neck and back of head are the only contact points with the floor.
  • Place one hand at the front of your chin.
  • Apply a firm force to the front of your chin to glide the chin backwards/downwards.
  • Hold for 30 seconds.
  • Repeat 3 times.

e) Base of Skull Stretch (Band)

sub-occipital muscle stretch with band

Instructions:

  • Loop a resistance band under the base of the skull.
  • Hold onto both ends of the band with your hands.
  • Gently pull the band forwards to create tension.
  • Tuck your chin in.
  • Slowly nod your chin downwards.
  • Aim to feel a stretch at the back of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

f) Left/Right Base of Skull Stretch

left right base of skull pain stretch

Instructions:

  • Look slightly downwards.
  • Place one hand at the front of your chin and the other at the back of your head.
  • Apply a firm force to the front of your chin to glide the chin backwards/downwards.
  • Turn your head slightly towards the opposite side that you are trying to stretch.
  • Whilst maintaining this pressure, proceed to slowly pull your head down towards the armpit.
  • Aim to feel a stretch on one side of the base of the skull.
  • Hold for 30 seconds.
  • Repeat 3 times.

h) Intense Stretch

back of neck yoga stretch

(Note: Do not attempt this advanced stretch if you have any serious neck issues.)

Instructions:

  • Lie on your back.
  • Brings your legs up and over your head.
  • (This will place pressure on the back of your neck and upper torso.)
  • Aim to feel a stretch at the back of your neck.
  • Hold for as long as you are comfortable.

Note: If the pain at the base of your skull is located behind the ear, you will likely need to perform Sternocleidomastoid Stretches.

3. Neck Traction

If you have Base of the Skull pain, it is likely that the structures in the neck will be compressed.


a) Resistance Band

neck traction

Instructions:

  • Tie a resistance band to a stationary object. (Height: ~3-4 feet)
  • Lie on the floor with your knees bent.
  • Wrap the band under the base of the skull.
  • Whilst still holding the band with your hands, slowly shuffle your body away from the anchor point.
  • Slowly let go and let the band pull on your head.
  • Move as far away until you can feel a stretch at the back of your neck.
  • Completely relax.
  • Hold for 30-60 seconds.
  • Note: Place a small towel between the head and the band to prevent your hair from being pulled.

b) Traction Devices

There are many mechanical traction devices available on the market that you can use to help decompress the joints in the neck.

(Note: Please seek guidance from a healthcare professional before using one!)

4. Activate Deep Neck Flexors

If you are not engaging the Deep Neck Flexor muscles, it is likely that you are overly relying on the muscles at the base of your skull.


(The Deep Neck Flexors are muscles which are situated at the back of the throat. They have the responsibility of holding the head/neck in a more neutral position.)

a) Deep Neck Flexor Activation

chin nod gentle exercise

Instructions:

  • Lie down on the floor with your knees bent.
  • Place a thin pillow underneath your head.
  • Make sure that your chin is not poking forwards.
  • Gently nod your chin downwards without engaging the superficial muscles at the front of your neck.
  • Aim to feel a subtle tension at the back of your throat.
  • Hold for 5 seconds.
  • Repeat 20 times.

Note: It may feel that you are not doing much in this exercise.

b) Chin Tucks

chin tuck for pain at base of skull

Instructions

  • Sit up right.
  • Slightly nod your chin downwards.
  • Keep the back of your neck as elongated as possible through the exercise.
  • Gently slide your chin backwards.
  • Avoid over tensing your superficial neck muscles.
  • Aim for a gentle contraction at the back of your throat.
  • Hold for 5 seconds.
  • Repeat 20 times.

If you feel that your neck is generally weak, please have a look at these Neck Strengthening Exercises.

5. Trigger Point Release

Tight muscles can refer pain to the base of the skull. Release these trigger points!


a) Upper Trapezius

upper trap release

Instructions:

  • Place a massage ball between the wall and the top of the Upper Trapezius muscle.
  • Apply a firm amount of pressure into the ball.
  • Search for a spot which refers pain to the base of the skull.
  • Hold this position until the pain releases.

b) Sternocleidomastoid

SCM Release

Instructions:

  • Locate the Sternocleidomastoid muscle..
  • With a pinch grip, feel for a prominent band of muscle on the side of the neck.
  • (Do not to press too deep as you may hit other sensitive structures of the neck.)
  • Gently massage the full length of the muscle until you find a spot which refers pain to the base of the skull.
  • Hold the release until the referred pain disappears.

6. Pain at Base of Skull on ONE side

If you have pain on the right or left side only, the muscles may be compensating for a rotation in the spine.


a) Twisted Spine

twisted spine, base of skull neck pain

If your torso is rotated towards the right: The muscles on the left side of your neck will tend to compensate in an attempt to keep the head looking forwards.

For more information: Exercises for Twisted Spine.

7. Address Posture

The following postures may predispose you to developing pain at the base of the skull. To completely resolve the symptoms, you will likely need to address the following.


a) Forward Head Posture

forward head posture

This is where the head is positioned in front of the torso.

For more information: Exercises for Forward Head Posture.

b) Dowager’s Hump

dowager's hump pain base of skull

This is a bump at the base of the neck.

For more information: Exercises for Dowager’s Hump.

c) Hunchback Posture

hunchback posture

This is where the upper back in slouched forwards.

For more information: Hunchback Posture.

8. Daily Tips

These tips are aimed at reducing the tension and compression at the base of the skull.


a) Work Ergonomics

If you sit in front of a computer for long periods, it is essential that your work station is set up ergonomically.

Make sure that you are NOT looking up at the screen.

Ideally – The computer screen should be angled upwards so that you are looking slightly downwards.

FREE eBook: How to Set up your Workstation.

b) Driving posture

If it is safe for you to do so, modify the position of the car seat to keep your posture upright.

c) Walking

head position with neck pain

When walking – you may need to fixate your gaze slightly lower than the horizontal.

This is especially true if you have Forward Head Posture, Dowager’s Hump and/or Hunchback Posture.

d) Keep moving!

Avoid staying in the same position for too long. (… especially if you are stuck in front of a computer!)

I recommend taking micro breaks at least every 30-60 minutes.

e) Sleeping position

neck pain base of skull sleeping position

Do not sleep with your chin poking forwards.

If you sleep on your back, it is important that your pillow is the appropriate height to encourage the chin in a slightly nodded position.


Conclusion

Base of the Skull pain may be related to tightness and/or tension in several neck muscles.

There could also be associated symptoms such as headaches, dizziness, tenderness and feelings of having a heavy head.

If your pain is directly related to these tight muscles, the exercises suggested on this blog post should help reduce your symptoms.

If ever in doubt, please seek medical guidance before commencing the exercises.


What to do next

1. Any questions?… (Leave me a comment down below.)

2. Come join me:

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3. Start doing the exercises!


About Mark Wong:

Mark is a Physiotherapist who has been helping his patients fix their posture for the past 11 years. He created the Posture Direct blog in 2015 with the goal of helping people fix their own posture.

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4 thoughts on “Neck Pain at Base of The Skull”

  1. Thank you for the helpful content! Really helped my neck issues, been looking for something like this for ages! Well done Mark.

    Reply
  2. Hi Mark,

    Could you please do an article on Patella Tendonitis?

    I have had persistent pain just below the knee cap on my right leg, and can’t walk up stairs, also walking on uneven surfaces creates more pain.

    Would really appreciate knowing which muscles to stretch, and how to strengthen the required muscles to stabilize my knee.

    Reply

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