I have basilar migraines and have had increasing issues with what my neuro is calling occipital neuralgia........she sees this pain as separate from the migraines but I am not so sure. Am curious what is the normal "path" that ON general exhibits. For me, the pain and pressure behind both eyes starts first, it can get so bad I really want to gouge out my eyes. Sometimes following that sensation I can get pain at the base of my skull and then that pain can travel throughout my scalp making it very sensitive. I can help relieve the pain at the back of my head by pushing on a trigger point at the base of my skull but haven't found much that will relieve the pain and pressure behind my eyes.

Is this occipital neuralgia? Is it normal for my first symptom to be the pain and pressure behind my eyes or does the pain at the back of the head usually the first symptom? Also, is it normal for both eyes to be involved? Thanks for any help!

I thought that I had ON after doing internet research, but later found that it was just tight back muscles pulling the scalp and neck tight. My pain doctor made the diagnosis.
Awful headaches-neck, scalp, eyes, shoulders-that nothing would stop. Rest was the only thing that helped,
Try remedial (or sports) massage and you should soon know if it is muscular as the masseuse will be able to see what condition your muscles are in, and after being treated the pain should go.
Continue with massage on a regular basis-every 2 or 3 weeks at least, to get on top of it.
Muscles have a memory and need to be retrained!
Try taking magnesium to remedy a magnesium deficiency which, as in my case, can cause of my muscles spasms and tightness.
Magnesium was the 'miracle cure' for me. So easy and fast acting. Expect results in a week or two, and continual improvement as long as you keep on it.
Research it on line. I take magnesium chloride in water.

Thanks for your response. I did a month of twice weekly physical therapy that included traction and massage and also exercises at home. The exercises made it worse as did the traction. The PT is now convinced that the problem is not in my muscles and it is not ON and he will report that to my neuro. Feel like I am back to square one except I now know 1 more thing that it is not. Still thinking that it is my migraines that are irritating the occipital nerve.

That's what you have to do-steadily explore your options and eliminate what you can.
Hard work with a sore head!
I'm having a bad time right now with pain where the neck joins the head, and also the shoulders. My joints tend to lock up a bit and the result is nerve irritation, which includes eye pain.
It was brought on by driving for nearly 3 hours a few days ago.
Have you had your cervical joints critically examined for spurs, narrowing, joints locked or out of alignment?