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Greater occipital neuralgia is a condition characterized by pain that typically originates from the occipital nerve, which can be impacted by various factors including muscle tension and irritation. One of the primary muscles associated with this condition is the semispinalis capitis. This muscle is located in the posterior neck and plays a crucial role in the extension and rotation of the head.

When the semispinalis capitis experiences spasms or tension, it can exert pressure on the greater occipital nerve. This pressure may lead to symptoms such as sharp pain, tenderness, or tingling in the occipital region and even radiating discomfort into the scalp. Thus, spasm in the semispinalis capitis is a significant contributor to the development of greater occipital neuralgia, making it the correct response in this context.

Other muscles mentioned may play roles in various neck and shoulder functions, but they are not typically associated directly with greater occipital neuralgia to the same extent as the semispinalis capitis.