Occipital Neuralgia: Causes, Symptoms and Treatment

People usually experience stabbing, electric shock-like sensations at the base of the skull, behind the ears, or in the upper neck.

Causes of Occipital Neuralgia

Occipital neuralgia causes sharp pain in the back of the head due to irritated nerves. Occipital neuralgia occurs

• Nerve irritation in the head
• Causes: Injury, muscle tightness, inflammation
• Source often hard for doctors to identify

It Has Been Linked to a Number of Medical Conditions, Including:

• A head injury
• Tense neck muscles
• Osteoarthritis of the cervical spine
• Occipital headache
• Neck tumors
• Cervical disc degeneration
• Infection or Gout
• Diabetes
• Inflammation of blood vessels

Conditions that Cause Occipital Neuralgia

• Cervical spondylosis
• Chiari malformation
• Spinal cord tumors (upper cervical region)
• Post-surgical complications (especially cervical spine surgeries)
• Herpes zoster (shingles) affecting the occipital nerve
• Compressive vascular abnormalities
• Occipital nerve entrapment due to fascial or muscular structures
• Chronic migraines with nerve sensitization

Symptoms of Occipital Neuralgia

Occipital neuralgia symptoms affect your head and neck. If you have occipital neuralgia, your symptoms may occur only briefly. Sometimes, symptoms are chronic (long-lasting).

Occipital headache pain may start behind one eye or at the back of your head. The pain may feel like:

• Throbbing or burning pain in back of head or behind ears
• Tenderness at the base of the skull
• Pain that radiates to the scalp, forehead, or eyes
• Scalp sensitivity
• Pain triggered by neck movement or light touch
• Aching or piercing sensations

When to Visit a Doctor for Occipital Neuralgia?

• Sudden, sharp, stabbing pain at the back of your head or upper neck.
• Pain that feels like an electric shock on one or both sides of the head.
• Pain persists despite rest, massage, or over-the-counter pain relievers.
• If you have diabetes, neck injury, or arthritis, which could be linked to nerve irritation.
• If the pain is getting worse, spreading, or affecting daily activities or sleep.

Associated Symptoms

• Scalp tenderness
• Pain behind the eyes
• Numbness or tingling in the head or neck
• Light sensitivity

Diagnosis of Occipital Neuralgia

Your doctor will inquire about your medical history as well as injuries in the past.

• Physical tests: Firm pressure applied to back of head to replicate pain
• Nerve block administered to numb nerve for relief assessment
• Blood tests or MRI scan for unusual cases
• Accurate diagnosis crucial for effective treatment

Treatments for Occipital Neuralgia

The first thing you'll want to do is to decrease pain and discomfort. For that, you can try the below things.

• Apply heat compression to the back of your neck.
• Rest in a quiet place.
• Massage the muscles in your neck that are tight and painful.
• Take over-the-counter anti-inflammatory medications such as naproxen or ibuprofen.

Muscle relaxants

The doctor suggests some occipital neuralgia medication or Anti-seizure medications like carbamazepine and gabapentin.

**Note: Take this medicine only when it is prescribed by a doctor.

Antidepressants, nerve blocks and steroid injections

• Nerve block for diagnosis & short-term relief
• Usually 2-3 shots over weeks
• Recurrence may require more injections

A surgery

An operation is uncommon, but it may be an option if your pain does not improve or returns despite other treatments. Surgical procedures may include:

Decompression of the microvasculature

Your doctor may be able to alleviate your pain by locating and adjusting blood vessels that are compressing your nerves.

Stimulation of the occipital nerve

To deliver electrical pulses to your occipital nerves, your doctor employs a device known as a neurostimulator. They can aid in the blocking of pain messages to the brain.

How can I Prevent Occipital Neuralgia Pain?

Although you may not be able to completely stop occipital neuralgia pain, there are ways to reduce flare-ups. Massaging and stretching your neck can help loosen tight muscles, which can trigger pain.

One exercise that may help is the chin tuck:

• Stand with your back against a wall, feet shoulder-width apart.
• Slowly tuck your chin toward your chest and pull your head back until it touches the wall.
• Hold for 5 to 10 seconds.

If this exercise makes your pain worse, stop and talk to your doctor.

Home Remedies for Occipital Neuralgia

• Apply warm compress to the back of the neck
• Gently massage tense neck muscles
• Rest in a dark, quiet room during pain flare-ups
• Try over-the-counter pain relievers cautiously

Lifestyle Changes for Occipital Neuralgia

• Incorporate daily neck stretching exercises (e.g., chin tucks)
• Reduce stress through yoga or meditation
• Take frequent breaks from screen time to reduce neck strain
• Stay hydrated and maintain a balanced diet