What you describe above is classic of occipital nerve pain, termed neuralgia when the cause is unknown or neuritis when it results from compressed nerves. If the muscles in your neck are tight around the area of the third and/or fourth vertebrae, that is sufficient enough to compress the nerves and cause pain. I also have shoulder problems which contribute to my neck problems, so it doesn't seem too strange to me that you're having this trouble. You may need to try a pain management doctor again for some relief. He/she should be able to do some nerve blocks to the nerves in your skull and the auricular nerve around the ear. The relief isn't permanent, but I take whatever I can get to get some relief from it. Read some of the posts here and you should see some similarities. Medications can bring some relief, but they are usually anticonvulsants and antidepressants. I find that vicodin doesn't really help the pain, it justs makes me indifferent to it, so it does help, just not directly as the other meds would. Take care and I'm sorry you're experiencing this pain. There is a lot of good information in the forums. Take some time to browse the posts if you haven't already. Take care