What Is Occipital Neuralgia?

Occipital neuralgia
is a pain disorder caused by a problem either in the occipital nerves of the neck or the branches from the cervical spine at C2 to C4 that form the occipital nerve. These occipital nerves run from the part of the spinal column where it meets the neck. They run up the neck toward the scalp and enter at the occipital groove at the back of the head.

This disorder can be caused by trauma from surgery or whiplash, or from anything that compresses or irritates the area. Some of the more common causes are:

  • Tumors
  • Neck lesions
  • Inflammation of the cervical vertebrae due to arthritis
  • Diseases that affect the nervous system
  • Tight muscles

Other physical problems such as diabetes, blood vessel inflammation or vasculitis or gout can cause occipital neuralgia. Some patients even develop the condition by spending extended periods of time with their head bent downward and angled in a forward position (turtle posture). With this large variety of contributing factors, some cases of the disorder have no distinct causes that can be found.

Occipital Neuralgia Symptoms

The symptoms of occipital neuralgia vary depending on the patient. Pain is generally located between the back of the head and the scalp. It can sometimes be confused with migraine or other types of headache, because the symptoms can often be very similar. The cause and effect are different, though, so it’s important that you get thoroughly tested if experiencing these symptoms.

Many patients feel an intense pain, a jabbing electric-shock-like experience that radiates in the back of the head and down the neck. The pain can be piercing or throbbing, and might be behind the ears or only on one side of the head. Some patients feel tingling, pain or numbness, while others report it affecting their eyes. The pain almost always starts in the back of the head and moves forward.

Every patient is different, so symptoms can last from hours to days, and might even be continuous. The pain varies from moderate to severe and can sometimes be totally disabling. If the condition is caused by compression and this compression isn’t relieved, permanent nerve damage can occur.

Diagnosing Occipital Neuralgia

Your doctor will begin the diagnosis by taking a thorough medical history. He or she will be most interested in any injuries you’ve had lately, as they can indicate damage to the area. The exam can be slightly painful, as your doctor will need to press on your neck to determine the origins of the pain. You’re likely to receive an injection known as a nerve block. If this injection stops the pain, it’s almost a certain sign that your problem is truly occipital neuralgia.

Occipital Neuralgia Treatment

Patients are most interested in occipital neuralgia pain relief. The same nerve block injection that your doctor used for diagnosis can be used as occipital neuralgia medication. It may take two or three shots spread out, one each week, to begin to break the pain’s hold and to get control of it.

Massage therapy can help, as can trigger point injections. Anti-inflammatory medication and muscle relaxers can give effective relief, as can antidepressants in the worst cases.

For patients who have exhausted all other medical options, occipital neuralgia surgery may offer relief.

If blood vessels are compressing your nerves, microvascular decompression can relieve the pain. Your doctor can also use a device known as a neurostimulator to block the pain messages from going to the brain.

Occipital neuralgia isn’t life-threatening, but it can affect your quality of life severely if not taken care of. Most people get relief with rest and minor medication, but if it doesn’t work for you, see your doctor for further treatment.

Occipital Neuralgia