The back of the head is painful by pressure, and the causes include occipital neuralgia and myofascial inflammation, as follows: 1. Occipital neuralgia: The occipital nerve is located bilaterally in the posterior occipital region below the outer in the vicinity of the mastoid process, and when the occipital nerve is painful, there is diffuse pain in all the areas innervated, but there is pressure pain in a fixed position at its pressure point. The pain is distending or throbbing in nature, presents episodes of 2-3 seconds at a time, and can be recurrent. Treatment of occipital neuralgia with pregabalin, gabapentin, can be combined with headache nin; 2. Myofascial inflammation: related to cervical spondylosis and capsular tenosynovitis. Patients mainly suffer from inflammation of the subscalp myofascia leading to secondary pain, usually with a feeling of tightness or heaviness in the head, and pressure pain when pressing the local muscles, mainly swelling pain. Myofasciitis is then treated with compound cloxazolazone, eperisone or tizanidine.