What are the causes of chronic pain in the head and occipital region?

  Chronic pain in the head and occipital region is defined as pain in the distribution area of the large and small occipital nerves in the posterior head. The posterior occipital and cervical sensation is innervated by the 1st, 2nd and 3rd pairs of cervical nerves. The posterior branch of the 2nd cervical nerve constitutes the greater occipital nerve, which exits superficially from the deep tissue at the midpoint of the line connecting the mastoid process and the midpoint behind the 1st cervical vertebra, and is distributed in the posterior occipital area equivalent to the part of the external auditory canal on both sides after the cephalocervical line. The anterior branch of the 3rd cervical nerve constitutes the lesser occipital nerve and the greater auricular nerve.  The small occipital nerve is mainly distributed in the upper part of the auricle and the skin of the lateral occipital area, while the large auricular nerve is mainly distributed in the front and back of the lower part of the auricle, the surface of the parotid gland and the angle of the mandible. When the three nerves are involved, they can cause pain in the posterior occipital and cervical regions and often appear as neuralgia. Because the posterior roots of the 1st cervical nerve are generally very small in development, posterior occipital and neck pain caused by spinal nerve disease in the upper cervical segment is collectively referred to as occipital neuralgia. Most of the frequent occipital pain is related to insufficient blood supply to the basilar artery, and its cause is mainly cervical spondylosis.  The basic pathological change of cervical spondylosis is degenerative degeneration of the intervertebral disc. The cervical spine is located between the skull and the thorax, and the cervical intervertebral discs have to do frequent activities under load-bearing conditions and are susceptible to excessive subtle trauma and strain and morbidity.