Occipital neuralgia describes a headache that characteristically occurs in the back of the head and upper neck. The pain occurs in the distribution of the occipital nerves, which are sensory nerves innervating the upper neck and the back of the head.
Cervical disk disease
Muscle spasms or tension
Trauma to the back of the head
Vasculitis, or inflammation of the blood vessels
Sensitivity to light
One-sided scalp pain
Burning pain that is often constant
Sharp pain that radiates from the base of the skull to the head and neck
Tenderness to pressure is noted along the course of the occipital nerve along with muscle spasms in the neck region. A nerve block performed by an interventional pain management physician can help confirm the diagnosis if it alleviates the pain. Diagnostic imaging can be ordered if the physician suspects some underlying cause such as a tumor.
Conservative treatment such as the application of warm compresses and over-the-counter pain medications are the first line of treatment.
If symptoms persist, physical therapy can be beneficial along with prescription medications such as muscle relaxants, antiepileptics, and tricyclic antidepressants.
If symptoms do not improve significantly, additional nerve blocks can be performed.
In rare circumstances, nerve decompression surgery may be necessary.