Occipital Neuralgia
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What Is Occipital Neuralgia?
Occipital Neuralgia causes pain in the back of the head, neck and scalp. This area is know as the occipital region. It is caused by inflammation of the nerves that run up and down this area. This condition can mimic a headache or even a migraine.
Sometimes being in one position for a long time or repetitively using the shoulders or neck can cause occipital neuralgia. It’s important to seek professional help in order to achieve the correct diagnosis which is based on a cluster of symptoms.
Occipital Neuralgia Anatomy
Occipital Neuralgia comes from irritation in the branches of the Occipital Nerve. The Occipital Nerves originates from the C2 and C3 spinal nerves. These spinal nerves exit the spine between C1 and C2, and between C2 and C3. 
Occipital Neuralgia Anatomy
The Occipital Nerve has 3 main Branches.
- Greater Occipital Nerve (GON)
- Lesser Occipital Nerve (LON)
- Third Occipital Nerve (TON)
What Does Occipital Neuralgia Feel Like?
Someone with Occipital Neuralgia will typically have a burning or throbbing sensation with intermittent shooting pain to the scalp or one or both sides to the head. Patients will describe their pain as intense, stabbing or sharp with symptoms lasting seconds to minutes. Sometimes, patients get pain behind the eye of the involved side. The pain can be triggered at rest or via movements like turning the head or placing pressure on the affected area.
What Triggers Occipital Neuralgia?
Occipital Neuralgia is caused by inflammation or irritation to the occipital nerves that run below the base of the skull. It could be due to an injury or tight muscles.
Other associated conditions may be but are not limited to:
- Head trauma
- Infection
- Diabetes
- Gout
- Tumors in the neck
- Osteoarthritis in the neck
Testing and Diagnosis of Occipital Neuralgia
There is no clear cut test to reveal a true diagnosis. A physical exam and neurological exam are done to look for abnormalities.
If nothing is revealed, the doctor may recommend imaging such as MRI which will show 3D objects. CT scans can show the shape and size of structures. Doctors can also use an occipital nerve block to help with diagnosing this condition.
Both migraines and occipital neuralgia may have symptoms of neck and sub-occipital pain. Migraine headaches, however usually include symptoms of nausea or light sensitivity whereas occipital neuralgia does not. Unlike several headache disorders, occipital neuralgia episodes are not likely to have symptoms of watery eyes or redness in the eyes. Contrary to tension headaches, occipital neuralgia episodes feel more like stabbing or shooting pain instead of a dull throbbing.
How do You Make Occipital Neuralgia Go Away?
Treatments for Occipital Neuralgia include heat application to the neck, sitting somewhere quiet, massaging irritable neck muscles, or taking OTC medications. If these don’t provide enough relief, physical therapy can be recommended to address stiffness and strength in the neck. Soft tissue massage to the muscles below the back of the head the may also be a key component to calming down the pain. This is also called Sub-Occipital Release. Keeping an active and healthy lifestyle with exercise and stretching to maintain flexibility can be a way to avoid this condition. Most doctors recommend these activities before seeking medical help.
What is Outlook for Occipital Neuralgia?
Occipital Neuralgia is a non life threatening diagnosis and the condition usually passes with rest, heat, and OTC medications. Even though occipital neuralgia is typically a painful diagnosis, it can usually subside via conservative measures listed above. If symptoms persist, then it is recommended to seek medical help.
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