What is Occipital Neuralgia?

HeadacheOccipital Neuralgia is a very distinct type of headache. It is characterized by electric shock-like, piercing, tingling, shooting and throbbing chronic pain in the back of the head, the upper neck region and just behind the ears. The pain is usually experienced by the patient on one-side of the head. Another characteristic feature is the path the pain takes. It starts in the neck and moves upwards to the head region.

Occipital nerves are two in number one on either side of the head. These nerves transmit the signals that are required for sensation on top of the head and in the back. Both the nerves originate from between the bones of the spine in the upper neck area and reach the scalp passing through the muscles present at the back of the head.

Causes & Risk Factors of Occipital Neuralgia:

Several factors may trigger the condition. These include:

  • The pain may start spontaneously without any particular reason.
  • A pinched nerve root in the neck.
  • Any previous surgery of skull or scalp.
  • Injury, infection and/or inflammation of the occipital nerve.
  • Neck muscles those are overly tight.
  • Presence of tumors in the neck region.
  • Nerve compression due to osteoarthritis.
  • Stress on occipital nerves. Persons with their heads positioned forward or downward tend to put stress on these nerves.
  • People suffering from diabetes, gout or vasculitis (inflammation of blood vessels) have higher chances of developing this condition.

Symptoms of Occipital Neuralgia:

These include:

  • Pain in the neck and back of the head is the most common symptom.
  • Pain in the scalp, behind the eyes and forehead.
  • Scalp of the patients with this condition is very tender to touch, which is experienced while washing the hair or lying on a pillow.
  • Their eyes are very sensitive to light.
  • Numbness in the affected region.
  • Pain in some people may radiate toward one of the eyes.


The diagnosis of this condition is usually confirmed by performing occipital nerve block. In this procedure, local anesthesia given in the affected area relieves the pain immediately.

Treating Occipital Neuralgia:

Treatment options depend on the symptoms and their severity.

  • Anti inflammatory medications and muscle relaxants can provide temporary pain relief.
  • Anti depressant drugs are prescribed in some cases.
  • Massage therapy could work wonders for some patients.
  • Occipital nerve block (temporary deadening of the occipital nerve), which is used as a diagnostic tool, also serves as a treatment option in some patients. In this procedure, once the occipital nerve is located at the back of the head (tender to touch); a combination of local anesthetic and steroids is injected into the ai???trunkai??i?? region of the nerve. The injected side of the skull becomes numb and relieves pain within minutes. Steroids in the injection start to show their effect by bringing down the pain in a couple of days. Depending on the affect of the numbness on the symptoms, a permanent treatment strategy is designed.
  • Cutting the occipital nerve surgically.
  • Burning the occipital nerve with the help of a radiowave probe.
  • Removing the nerve by injecting a small dose of toxin.

In people whose occipital nerve is permanently deadened, permanent numbness on the scalp to an extent is evident. In people where occipital nerve is not eliminated, the nerve is decompressed by the removal of any scar tissue present. Another option is implantation of a pacemaker like device, occipital nerve stimulator that stimulates the occipital nerve with the help of electricity that results in tingling feeling rather than distinct pain.

If Occipital Neuralgia is not treated with occipital nerve block, patients are often advised not to opt for any of the other surgical procedures.

3 responses to What is Occipital Neuralgia?

  1. question; would this condition leave a person with a chronic (8 months approx) stiff head & neck as
    well as most of the other symptoms and swollen lymph nodes in neck
    as well, but not all the time. Can’t turn my head too much when driving, etc.

  2. You may want to check into cervical dystonia. I have both occipital migraines and cervical dystonia,
    but have not found medication to relieve either – yet.

  3. I am experiencing wjat seems to be thia. Started at work today and almost feels like a spasm and electrical all at the same time. Pain is on the left side at the top of the occipital bone. Scalp is tender, very tender. I have cervical dystonia and oromamdibular dystonia as well. Had an MRI about 2the years ago which showed cervical spondylosis and apurs at c3-4 and c5-6. No infringement of the spinal cord at that point. I receive botox 3-4and tomes a year for the dystonia and take oral meds. 2 mg of Cogentin, 1-2 mg Klonopin and Zanaflex as needed. This new symptom along with the increase of tremors jn other parta of my body not directly affected by dystonia. Left tricep tremor, both thumbs, right leg at the inner thigh and hamstring…

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