I, too, was diagnosed with occipital neuralgia after suffering for 2 months with extreme, flaming pain that started at the back of the head and radiated to the crown. The pain was so bad that the crown of my head was tender to the touch. The neurologist prescribed Qlipta, Nurtec, and Ubelvy; none worked. I had to sleep upright with an ice pack. This went on for two months without relief; the night was always worse. I was referred to a headache specialist who identified the symptoms as classic occipital neuralgia. A nerve block was administered, and I had temporary relief for four days, and then the pain returned. I was prescribed a low dose of Gabapentin. Once the dose was increased to 300 mg, I had good pain relief for 3 weeks, and then the pain returned. I have been on 600 mg for 1 month now, and the pain, while still present, is tolerable. I would say it's 2/3 on a scale of 1-10. I am scheduled for another nerve block next month, and I am hoping that, along with the current dose of Gabapentin will eliminate the pain. I also did 4 weeks of PT which has provided some relief.