I get the pinching and grating, but also this other sensation. It's not easy to describe it but the way I put it is relatively close. Seems to fit with some descriptions of neuralgia.

It's not that the area is hot to the touch if I touch it with my hands. It's just the sensation that I feel in my neck and head. It's a combination of this feeling plus the pressure and pain in the rest of the head together.

The one thing I know for sure is that my muscles are constantly toned and I have some nervous system issues (constantly in fight or flight).

Hard to say if there's anything else at play. Unfortunately it's just super uncomfortable and a lot of pain 24/7.

I'm doing physical therapy, icing, heat, posture work, psychological work. Hopefully something gives some amount of relief at some point.