The greater occipital nerve is located in the head and neck. Chronic pain from this nerve is called neuralgia. The cause is often unknown. Sometimes when the nerve passes through a muscle it gets stretched and becomes painful.
Researchers have shown some changes in anatomy such as bone spurs or large veins can cause this problem. Some cases of severe arthritis affecting the upper part of the neck have been reported as a cause. Without a known cause it can be difficult to treat. Even with treatment the painful symptoms can come back.