Occipital Neuralgia

What is Occipital Neuralgia?

Occipital neuralgia is a condition in which the nerves that run from the top of the spinal cord up through the scalp, known as the occipital nerves, are inflamed or injured. Common symptoms include pain in the back of your head or the base of your skull.

Because the symptoms can be similar to those of migraine or other types of headaches people may not accurately identify the type of headache they are experiencing. Because treatments for the many types of headaches are very different, it is important to see your doctor to get the right diagnosis.

What are the Causes?

Occipital neuralgia occurs when there is pressure or irritation to your occipital nerves, perhaps because of an injury, tight muscles that entrap the nerves, or inflammation. Many times, doctors are unable to identify a cause for it.

A variety of medical conditions are associated to it, including:

  • Trauma to the back of the head
  • Neck tension or tight neck muscles
  • Osteoarthritis
  • Tumors in the neck
  • Cervical disc disease
  • Infection
  • Gout
  • Diabetes
  • Blood vessel inflammation

What are the Symptoms?

Occipital neuralgia can cause intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms include:

  • Aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp
  • Pain on one or both sides of the head
  • Pain behind the eye
  • Sensitivity to light
  • Tender scalp
  • Pain when you move your neck

What are the Treatments?

  • Some things you can try in order to relieve your pain include:
  • Apply heat to your neck.
  • Rest in a quiet room.
  • Massage tight and painful neck muscles.
  • Take over-the-counter anti-inflammatory drugs, like naproxen or ibuprofen.

If those don’t help, your doctor may prescribe medications for you, including:

  • Prescription muscle relaxants
  • Antiseizure drugs, such as carbamazepine (Tegretol) and gabapentin (Neurontin)
  • Antidepressants
  • Nerve blocks and steroid shots. The nerve block that your doctor might do to diagnose your condition can be a short-term treatment, too. It may take two to three shots over several weeks to get control of your pain. It’s not uncommon for the problem to return at some point and to need another series of injections.

Surgical treatment is rare, but it might be an option if your pain doesn’t get better with other treatments or comes back.

Surgery may include:

  • Microvascular decompression. Your doctor may be able to relieve pain by finding and adjusting blood vessels that may be compressing your nerve.
  • Occipital nerve stimulation. Your doctor uses a device called a neurostimulator to deliver electrical pulses to your occipital nerves. They can help block pain messages to the brain.

Occipital neuralgia is not a life-threatening condition, and most people enjoy effective pain relief by resting and taking medication. But if you are still experiencing pain, consult with your doctor to find out if there is another problem that’s causing your pain.

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