Occipital neuralgia triggers intense pain that begins in the neck and travels upward to the scalp, causing painful headaches. Irritation of the occipital nerves causes the headaches, which are characterised by stabbing pain or an electric shock sensation in the head. Several treatments are available to relieve pain and reduce nerve sensitivity.
The term "neuralgia" is used to define pain that occurs along the length of a nerve. In occipital neuralgia, pain is felt in one or both of the occipital nerves. Occipital nerves are found in the second and third vertebrae in the neck in the area where the neck and spine meet. One occipital nerve travels up each side of the head.
Symptoms of occipital neuralgia include burning, throbbing or shooting pain in the upper neck, back of the head and in the area behind the ears. Pain may also be felt in the forehead, behind the eyes and in the scalp. Scalp tenderness often accompanies pain, making it difficult to carry out routine activities, such as hair brushing. As pain increases, you may find that bright lights bother your eyes. Occipital neuralgia usually affects one side of the head, although some people experience symptoms on both sides of the head, according to the American Association of Neurological Surgeons.
Occipital neuralgia can occur if the muscles in the neck are too tight and may be a result of keeping your head in a downward position for extended periods of time. When the muscles tighten, the occipital nerves are pinched and become irritated. Tumours, lesions or arthritis in the neck may cause compression of the occipital nerves. Other possible causes of occipital neuralgia include head or neck trauma, cervical disc problems, diabetes, infections, gout or blood vessel inflammation. In some cases, there is no known cause.
A diagnosis is made based on your medical history, your symptoms and an examination. Your doctor may suggest that you have a computed tomography (CAT) scan or a magnetic resonance imaging (MRI) scan. These tests produce cross-sectioned images of your neck, allowing your doctor to detect any areas of nerve compression or structural problems in the neck or spinal canal.
Occipital neuralgia may be relieved by simple home care measures. Applying heat to the area in conjunction with taking anti-inflammatory medication or muscle relaxants may loosen tight neck muscles and eliminate symptoms. Anticonvulsant drugs and physiotherapy can also be helpful in relieving pain. Nerve blocks may be used to diagnose occipital neuralgia and relieve pain. During a nerve block, steroids and a local anesthetic are injected through your scalp into the nerve, temporarily deadening the occipital nerve.
Surgery may be recommended if pain is severe and does not respond to other treatments. Occipital nerve stimulation is used to relieve pain by implanting a small electrode in the back of the neck. The electrode generates electrical impulses to the nerve, alleviating pain. Microvascular decompression can be used to move blood vessels that may be irritating the occipital nerve. This surgical procedure allows nerves to recover from constant irritation, relieving pain. Some people may be helped by procedures that permanently deaden the nerve.