Occipital neuralgia can be caused by various diseases or as a result of a pinched or damaged nerve. It occurs when there is a problem with the two occipital nerves in the neck. Those with occipital neuralgia experience an intense, chronic headache that begins in the base of skull or neck and moves to the scalp. This condition often interferes with daily activities, but it can be effectively treated by a peripheral nerve surgeon.
Symptoms of Occipital Neuralgia
Occipital neuralgia causes intense pain in the back of the head and neck that often feels like an electrical shock. The pain often travels to the scalp. The pain from occipital neuralgia is chronic and can interfere with daily activities.
Some other symptoms of occipital neuralgia may include:
- Burning, throbbing, or sharp pain at the base of the skull
- Pain that radiates to behind the eye
- Pain that occurs on one or both sides of the head
- Increased sensitivity to light
- Tenderness in the scalp
- Pain when moving the neck
Risk Factors and Possible Causes
Occipital neuralgia often has unknown causes. There are several factors that may increase your risk of developing the condition. These include:
- Current or prior neck or head injury or trauma such as whiplash
- Past surgery to the neck and head
- Abnormality in the spine, neck, or head
- Chronic tension and strain on the neck
Occipital neuralgia may be caused by an injury or irritation of the occipital nerves in the neck. It can be the result of the following:
- Underlying diseases such as diabetes, osteoarthritis, rheumatoid arthritis, or gout
- Direct trauma to the back of the head
- Benign or malignant tumors or cysts in the back of the neck or throat
- Cervical disc disease or degenerative disc conditions
- Infection that triggers inflammation of the tissues and muscles surrounding the occipital nerves
- Inflammation of the blood vessels
- Extremely tight neck muscles
- Poor posture
Diagnosis and Treatment Options
If you are experiencing sharp pain in the back of your head and neck, consult with a peripheral nerve surgeon for a diagnosis. To diagnose the condition, physical and neurological exams will be done. In addition, imaging tests of the head and neck will be ordered. A nerve block may be done to determine if a problem with the occipital nerve is the cause of the pain. If the patient has relief with the nerve block, it can confirm the diagnosis.
Once the diagnosis is made and any underlying causes are ruled out, treatment options will be recommended based on the patient’s personal needs. The goal of treatment will be to stop or relieve the pain.
Some conservative treatments for occipital neuralgia include the following:
- Massage. Massage therapy may be used to help reduce the tightness in the neck muscles.
- Heat. Applying heat to the affected area can help provide relief from pain.
- Physical therapy. Physical therapy may include exercises to help stretch and strengthen the muscles in the neck and back.
- Medication. Medications such as non-steroidal anti-inflammatory drugs, muscle relaxants, antidepressants, or antiseizure medications may be used to help manage pain and symptoms.
- Nerve block. An occipital nerve block is often used to block the pain signals that travel to the brain.
- Injections. Steroid or Botox injections may be used to decrease inflammation of the occipital nerve.
If the symptoms of occipital neuralgia are severe, interfering with daily activities, and conservative treatments have not provided relief from the pain, surgery may be recommended to take pressure off the pinched nerve. Some surgical options for occipital neuralgia are:
- Occipital nerve decompression surgery
- Nerve releases surgery
- Occipital nerve stimulation
- Spinal cord stimulation
Contact a Baltimore Peripheral Nerve Surgeon
Dr. Williams can perform nerve decompression surgery to eliminate pain and pressure from occipital neuralgia. If you need to find relief from the pain caused by occipital neuralgia, contact Dr. Williams for a consultation. To schedule an appointment in our Baltimore office, call us at (410)709-3868 or fill out our contact form online.
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