Effective Solutions of Sub Occipital Pain with Manual Techniques

Blog Image about Relief from Sub Occipital Pain – Effective Solutions with Manual Technique (1)
Effective Solutions of Sub Occipital Pain with Manual Techniques

Suboccipital pain is a common type of chronic neck pain. It affects millions of people around the world, which makes it one of the most common types of neck pain. 

Even though the primary cause of this type of pain is unknown, there are effective treatment options that can help relieve the symptoms. 

If you’re reading this article, it’s probably because you already know something needs to change in your life and that you’ve tried everything else. 

There are so many reasons why we need to take action against suboccipital pain – not only for our health but for our well-being as individuals too. 

What is Suboccipital Pain? 

x-ray visual of sub occipital pain of a man

It is a condition that is commonly caused by tightness in the muscles and connective tissues around the base of the skull. 

It can also be caused by compression of the nerves in this area. This condition can be very debilitating and cause a great deal of pain.

Causes of Suboccipital Pain

The suboccipital muscles attached to your occiput can be tender and sore if you sit at a desk or in front of a computer for long periods of time. It is common for people who sit for long periods of time to develop tension headaches. These muscles help to keep the head in place and prevent cervical vertebrae misalignments.

  • Prolonged tilting of head especially while working at the desk or when reading
  • Prolonged tilting of the head backwards or on the side especially when you are tucking a phone between ear and shoulder , when watching a screen located to your side, when the person you are talking to sits next to you, when doing painting jobs or when climbing
  • Cold draught which happens when your muscles are tired and got shortened for a longer time and you got exposed to cold draught (I suggest you put a scarf around your neck to avoid this)

Manual Techniques Never Seen for Reduced Neck Range of Motion that may Create Pain

1. Sub Occipital Pain Midfoot  Massive Supination

Asian woman doing to put a lock on the hindfoot sub occipital pain

You’ll probably see this with a lot of clients that you’ll have one foot that’s got massive supination and the other one that’s not as supinated. 

Now there are a couple of ways we can address that we can have a look to see if it’s the midfoot, the cuboid muscle that is cuboid bone, that has been locked up. 

That’s because of the torque or the pull between the tibialis anterior and the perennials that share in a common attachment point of the midfoot. 

Their action is to draw up that foot arch, we can have some jointly restrictions going on with the navicular head and the talus bones. It can be either of these structures that creates a problem, let’s assess in this video.

Let me demonstrate how I’ve achieved amazing results from it.

  • Put a lock on the hindfoot, and then put your hands on the forefoot that is free floating.
  • Move it back and forth to see if we are able to unlock the intercuneiform joints. Occasionally you feel a click from the action or, sometimes, you’ll hear the click. This is NOT high velocity thrusts but simply the joint moving over surrounding bones or a nitrogen bubble release.
  • Then move to the second point. Feel if the navicular or talus bones are sitting just a bit more anterior-lateral than normal. 
  • Both thumbs on the bone/s, rock the ankle into some dorsiflexion for about 30 seconds, while they notice any pain and/or stiffness. It can be quite uncomfortable.

2. Sub Occipital Pain Recurring tightness in Upper Cervical Muscles or (suboccipital muscles)

x-ray visual of sub occipital pain of a woman

Are you a practitioner with clients or patients who come to see you who have constant tightness in their lower cervical muscles, specifically the ones that run along the deeper gutter of the neck, and attached to the base of the skull? 

They’re referred to as our suboccipital muscles. These are the muscles that our patients often say are very tight. Comments like “It doesn’t matter how much I try it doesn’t seem to help the tightness”

In the long run, we are able to do lots of work with neuromuscular techniques. 

We can use exercises to increase muscle energy as well as glides, and we can also do joint capsule mobilization, however this is more universal and something I’ve seen in my clinic that’s gained a bit longer duration for both the patient and the client. 

Following the patient’s evaluation of the cervical movement.

Let me demonstrate how I’ve seen amazing results from it.

  • Ask the patient to go through upper cervical ranges. They will chin poke and chin tuck; trickier to do so I ask them to make a double chin. 
  • They will lie in supine, you’ll need to feel your hands descending to the table, and your neck feels as if it’s lying flat in front of the pillow. 
  • Have them bend their knees and put their feet flat, creating the bridging motion by elevating the buttocks off the table. They are asked to activate the gluteus maximus, which are those massive bionics power drivers to lift the pelvis and hips off the table. 
  • We can experience some beautiful stretches all the way to that thecal area, and coming down the full line of the spine
  • When we get them into a sustained bridge we then increase the pull at the top of this line by adding a pull or drag on the occipital ridge. We are pulling the neck into flexed traction and it works brilliantly for giving extra stretch and length in resting to the back fascial lines of the body.
  • Apply 3 times before you reassess.

3.  Sub Occipital Pain Severe Lateral Cervical Tenderness

Severe Lateral Cervical Tenderness of a man sub occipital pain

I’ve been seeing clients coming with really restricted neck ranges and quite extreme cervical tenderness on the lateral side. 

It is possible to perform a lot of work on the neck. However, what we really need to do is to discover how we can assist those clients with homework maintenance. 

We also need to assess so we can get a more detailed look at the things taking place that require change. 

This treatment always occurs after conducting an assessment on the client.

Let me demonstrate how I’ve seen amazing results from it.

  • Check the ranges of movement through flexion, extension, rotation and lateral flexion. Note before and after ranges.
  • We are addressing the deep and superficial arm lines of the anatomy trains. We look at the links between the entire pathway from neck, shoulder, arm, wrist and hand. This is important because a break in the continuity of any of these will make myofascial pain changes to the patient.
  • If there is restriction in the neck, I will move my attention to the hand and to the finger webbing. This may sound odd but I want you to check your necks and webbing and see if you can’t notice a correlation between tenderness and reduced neck movements.
  • Apply a lubricant rather than oil to your fingers. Oil is too slippery and will not give enough grip as you glide proximal to distal between the MCP joints.
  • Make sure that the patient relaxes their arm. Apply your thumb and fingers in the skin just below the MCP joints and then draw them through the webbing between the fingers and off.
  • Go through the web at least three or four times. After that, the same procedure through all the webs to pick up any tightness, tension or bound feelings between each finger knuckle to skin.
  • Do the same process to the other arm. 
  • Once complete, we will retest ROM and if there is a significant result then this will be part of the home care routine.

4. Trigger point therapy

This therapy involves applying pressure on specific muscles or bands within the muscle that create myofascial pain syndromes. 

These muscles seem to react well to triggering whether it be by compression, squeeze/flushing, acupressure or dry needling. 

Can must be used to confirm that it is the muscle you are addressing and not other neural tissue. 

Some patients love it though it can be quite painful during the application.

5. Massage

Massage is one of the most vague definitions in the dictionary for ways to relieve muscle tension. It includes glides, effleurage, kneading and should include techniques including NMT, MET, MFR. 

The old comments like “improve blood circulation” are no longer valid, nor is drinking water post a massage to remove toxins.

Probably the greatest value from receiving a massage is the activation of the parasympathetic nervous system. The body calms to serotonin, dopamine, oxytocin and more feel good chemicals aroused in the body. 

There is true value in this kind of relief, especially with clients under a lot of stress.


Stretching is another great way to relieve muscle tension and improve resting tone and active range of motion. There are many different stretching exercises that you can do at home or at work. 

Talk with your remedial therapist or exercise practitioner who will find ones that work best for you and do it regularly throughout the day. 

Remember to breathe deeply while stretching as this will also help relax your muscles.

These manual techniques can be helpful in treating this suboccipital pain and many other types of pain experienced in the body. 

If you’re not sure which techniques are right for you, consult with a qualified massage therapist who can help you choose the best option based on your individual needs.

I have found that these techniques are often very effective in relieving suboccipital pain. 

By applying techniques more distal to the neck can help to release tension in the muscles and tissues around the neck and head. 

This can often provide significant relief from pain and help to improve the range of motion. 

For a better understanding of these techniques please click on the link to the video below.


Watch This Video and Subscribe to Learn More!

You tube – https://www.youtube.com/watch?v=Rt-eDY7PLKc


National Library of Medicine, BMC Musculoskelet Disord. 2017 Published online 2017 Sep 5.Effectiveness of a specific manual approach to the suboccipital region in patients with chronic mechanical neck pain and rotation deficit in the upper cervical spine: study protocol for a randomized controlled trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584013/

National Library of Medicine, Author Tom George; Prasanna Tadi, Update January 10, 2022. Anatomy, Head and Neck, Suboccipital Muscles https://www.ncbi.nlm.nih.gov/books/NBK567762/