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The Flare-Up Checklist

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The Flare-Up Checklist

For occipital neuralgia flares. Most flares give you a warning sign before the real pain starts. These steps work best at that first warning. Do them in the same order every time, so when a flare hits you never have to stop and think.

1
At the first warning
the first 30 minutes

Stop now, not after you finish the task. That familiar tightness at the base of your skull is the warning. Acting now can keep this to a bad hour. Waiting can turn it into a three-day flare.

Moist heat, 20 minutes. Warm (never hot) wrap around the curve where your skull meets your neck. Scalp too sensitive for heat? Use wrapped cold, 10 min

Away from the screen while the heat works. Sit somewhere comfortable, eyes closed if you can, shoulders relaxed, slow breathing.

2
The next few hours
keep ahead of it

Gentle sustained pressure into the hollows at the skull base. Two minutes with the massage tool, warm first, then press. Or ten minutes on the traction cradle.

Easy movement. A short walk and slow, gentle neck movement. Stop anything that makes the pain worse.

If the pain is still building after heat: a TENS session. Follow your pad placement rules exactly. Never the front or sides of the neck.

Repeat the heat if the tightness returns. Every 2 to 3 hours is fine. Postpone what desk work you can, and take a screen break every 30 minutes.

3
Protect the night
how you sleep tonight decides tomorrow

One last 20-minute heat session before bed.

Sleep on the cervical pillow, back or side. Neck supported, pressure off the skull base, no stomach sleeping tonight.

Go to bed a little earlier than usual. A long evening sitting with your head bent forward feeds the flare you are trying to stop.

Tomorrow: write down what set this one off. Long desk day? Poor sleep? Stress? Spotting your triggers means fewer flares to deal with.

Keep it all in one place

Put the kit together on a good day, before you need it. Mid-flare is the worst time to be hunting for things.

  • Microwavable heat wrap
  • Soft gel cold pack + towel
  • Massage tool
  • TENS unit, pads charged
  • Traction cradle
  • Cervical pillow on the bed
  • This checklist

When it is more than a flare, do not use this checklist:

Call 911 now: a sudden, severe headache unlike anything you have had before · fever with a stiff neck · sudden weakness, numbness, face drooping or trouble speaking

Call your doctor soon: pain that feels very different from your usual flares, or flares that are steadily getting worse

Educational content, not medical advice. Medical disclaimer. The full kit and every technique: the Flare-Up Kit guide. backpainsleep.com