Occipital Neuralgia

Overview

Occipital neuralgia is a condition that causes nerve pain in the back of the head and upper neck. It occurs when the occipital nerves, which run from the top of the spinal cord to the scalp, become irritated or inflamed.

The pain is often sharp and can spread from the base of the skull to the scalp.

Urban Spine and Joint

Symptoms

Common symptoms of occipital neuralgia include:

  1. Sharp, shooting pain in the back of the head
  2. Burning or aching pain that may be constant
  3. Pain that radiates from the base of the skull to the scalp
  4. Sensitivity to light
  5. Tenderness in the scalp or along the nerve pathway
  6. Pain on one side of the head

Pain may be triggered by touching the scalp or moving the neck.

Causes

Occipital neuralgia can be caused by irritation or injury to the occipital nerves.

Common causes include:

  1. Neck muscle tension or spasms
  2. Cervical disc disease
  3. Arthritis in the neck
  4. Trauma to the back of the head
  5. Diabetes
  6. Infections
  7. Gout
  8. Inflammation of blood vessels (vasculitis)

In some cases, the exact cause is not identified.

Diagnosis

Diagnosis begins with a medical history and physical examination. A doctor will check for tenderness along the occipital nerves and assess neck movement.

A diagnostic nerve block may be performed. If pain improves after the injection, it helps confirm the diagnosis.

Imaging tests such as MRI or CT scans may be used if an underlying condition is suspected.

Treatment Options

Treatment usually starts with conservative care.

Common treatment options include:

  1. Warm compresses
  2. Over-the-counter pain medications
  3. Physical therapy to reduce muscle tension
  4. Prescription medications such as muscle relaxants, anticonvulsants, or antidepressants

If symptoms persist, occipital nerve blocks may be used to reduce inflammation and relieve pain.

In rare cases, surgical nerve decompression may be considered when other treatments do not provide relief.