Occipital neuralgia is a rare form of chronic headache, that derives from the distribution of the occipital nerves. The occipital nerves are the sensory nerves running from the top of the spinal cord, up and into the scalp. Sometimes they reach as far as the forehead, but never cover the face, or the area around the ears. Specifically, they originate in the second and third vertebrae of the neck.
The cause of this type of pain is from inflammation, or injury to the greater occipital nerves (GON). However, this doesn’t explain the direct cause. Some researchers speculate that it derives from arthritis, diabetes, infections, injury to the neck or head, and tumors.
Unfortunately, occipital neuralgia symptoms are often confused with other types of headaches, such as migraines. This happens simply because the symptoms are sometimes quite similar. However, the treatments are different for each type of headache, so be sure to consult with a medical professional for clarity, and correct treatment.
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First Report of Occipital Neuralgia
Interestingly, the first clinical case published about occipital neuralgia symptoms was published in 1821 by two Spanish doctors, Jose Benito Lentijo and Mateo Martinez Ramos. In their report, they called it cervico-suboccipital neuralgia.
Occipital Neuralgia Causes
As with other types of neuralgia pain, there are many causes for occipital neuralgia. Primarily, it occurs when there’s unusual pressure or irritation to your occipital nerves.
Pressure may occur because of muscles tightening, and trapping the nerves. This may be a result of an injury to the area of the neck and head. Additionally, any kind of inflammation to these nerves will cause pain.
Specific areas of pain may manifest in the following locations or ways.
When arthritis develops over time, long-term inflammation may set in, and cause a great deal of strain on the occipital nerves which leads to occipital neuralgia.
Diabetes causes inflammation of the nerves, and sometimes leads to occipital neuralgia. In fact, more people with diabetes develop this condition than those with arthritis. Of course, both causes might contribute to occipital neuralgia simultaneously.
Neck Trauma and Nerve Compression
If you sit for extended periods of time with your head held in one position, it may develop into trauma in your neck. You may also develop nerve compression at the base of the neck, which over time, will lead to occipital neuralgia.
Occipital Nerve Compression and Tenseness
Sitting in the same position over long periods of time, especially when the head bends forward or downward may result in occipital neuralgia due to compression of the occipital nerve.
Tumors around the cervical spine, or in the neck or throat, may cause inflammation and stress on the occipital nerves.
Occipital Neuralgia Symptoms
Occipital neuralgia is an intense pain originating in the back of the neck and head. Sometimes, it is so severe that it feels like an electric shock, while others report sharp stabbing pain symptoms.
In addition to being quite rare, the occipital neuralgia symptoms are easily confused with migraines, or other types of headaches. For instance, migraine pain is usually throbbing and takes place over a few hours. However, with occipital neuralgia, the pain is sharp and intense with short bursts of pain.
Therefore, you must continue to do your research, and consult with your medical professional, for specific diagnosis and treatment.
If a sharp, stabbing pain in your tooth occurs simultaneously with pain in the back of the neck or head, it might be a symptom of occipital neuralgia.
Dizziness or Light-Headedness
The areas affected by occipital neuralgia, for this condition, are the eyes and ears. You might feel faint, and when sleeping, you might feel like you are floating or swimming.
If your nasal congestion also coincides with chronic head pain, dizziness, and nausea, you may be experiencing occipital neuralgia.
This is a condition that comes from tight, or misalignment of the muscles, which makes it difficult to turn your head without stabbing or throbbing pain, and is sometimes a symptom of occipital neurology.
Scalp sensitivity is a common symptom because the occipital nerves run through the back of the scalp. So, it’s easy to see why this type of pain affects the sensitivity of the scalp. It might feel like inflammation, itching, irritation, numbness, or tingling. In some patients, washing hair or lying on a pillow becomes nearly impossible.
Sensitivity to touch over the painful area is one of the most prevalent occipital neuralgia symptoms.
Vertigo is a sensation of being out of balance, which may also include dizziness or a feeling of everything swirling around you. If your vestibular system is adversely affected by occipital neuralgia, you may experience vertigo.
Pain behind the eyes, and blurriness, occur more often in this type of head pain than any other. Conversely, with other types of headaches, you find more eye-watering, and redness.
This symptom is characterized by constant ringing in the ears in addition to other noises such as roaring or crackling.
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Occipital Neuralgia Diagnosis
Occipital neuralgia is difficult for even the most seasoned medical professionals to diagnose, because the symptoms are like other types of headaches, such as migraines.
Diagnoses involve a physical examination by your physician, in which they apply pressure along the occipital nerve. Interestingly, your physician may treat it with a nerve block, which helps confirm the diagnosis that it is the occipital nerve that is causing the pain. If the nerve block eliminates the pain, your doctor may perform a more permanent procedure.
As with many pain-related illnesses, it is advisable to keep a “pain diary”, and take it with you when you see your doctor. By doing so, you take an active role in helping your doctor make a more accurate diagnosis and treatment plan.
Occipital Neuralgia Treatment Options
Treatment for occipital neuralgia involves a joint effort by you and your doctor. The main goal is to relax, and release the muscles that put pressure on the occipital nerves.
Occipital Release Surgery is a decompression of the greater occipital nerves. This is an outpatient procedure performed while the patient is under general anesthesia. During this surgery, the surgeon cuts through the back of the neck to release the occipital nerves from the surrounding connective tissue to decompress the nerves.
However, in this same procedure, the surgeon may also decompress other nerves contributing to the pain, such as the dorsal occipital nerves, and the lesser occipital nerves.
Unfortunately, even after this procedure, the pain sometimes returns. Further surgery may be necessary after one year, but is only advisable as a last resort, because it often results in permanent numbness.
Non-surgical options may include the following treatments:
- Radio-wave probe.
- Eliminate the nerve with a small dose of toxin.
A down-side to these two treatments is that they might deaden the nerve, which results in permanent numbness.
Tip o’ the Hat to Johns Hopkins Medicine.
In one study, a 78-year-old woman, with symptoms of neck pain and electrical sensations, received 5 acupuncture treatments. The results showed a significant reduction of pain, after a single treatment.
In an abstract, pediatric patients with ventriculoperitoneal shunts, and occipital headaches, were given nerve blocks. The results showed headaches improving in every patient. In addition, 29% were symptom-free 11-12 months after the treatment.
High Cervical Spinal Cord Stimulation
In a review, five patients with occipital Neuralgia were given high cervical SCS treatment. Two of the patients had a 50% reduction in pain, and went on to get permanent implantation.
Also, in this same review, 18 patients who underwent cervicomedullary junction SCS, 50% were successful and went on to get permanent implantation.
Occipital Neuralgia Treatment at Home
Diet and Supplements that Help Ease Pain
For chronic pain treatment of any type, start with your diet. For instance, pay attention to foods that are rich in B vitamins. For nerve regeneration, some people take a vitamin B12 supplement.
Additionally, add foods to your diet that are rich in fish oils, or flaxseed oils, because of the help they offer in reducing inflammation around nerves.
Magnesium is also helpful in the reduction of stress and pain. So, look for foods that are high in magnesium, as well as over-the-counter supplements.
In addition to these suggestions, also drink plenty of water – muscles need hydration! Also, avoid processed foods and reduce your sugar intake wherever possible.
Try Out a Variety of Relaxation Methods
Relaxation is something everyone needs, but especially those with chronic pain. Often, it is tense muscles that cause the pain, so it makes perfect sense to find a way to relax, and soothe your muscles. Find a quiet spot in your home which may be your favorite reclining lounger, or simply lay down on your bed in a comfortable position. Then, apply heat to the neck muscles to melt away the tension and pain.
Cranial Osteopathy Massage
For this massage technique, you will have to search for medical professionals who train for this type of pain relief. A good place to start is The American Academy of Osteopathy.
Be Aware of Your Sleeping Habits
It isn’t surprising that sleep is a part of the cycle of pain. It starts with not enough sleep, then the following day’s pain increases. That follows with difficulty sleeping the next night. Aside from the amount of sleep you get, is the issue of how you sleep, or in other words, the position of your head when you sleep.
Guidelines suggest not sleeping in a crooked position that makes your head and neck muscles stiffen. Also, pay attention to your pillow, and ensure that it supports your head, while keeping it at the same level as your neck.
Tip o’ the hat to PainDoctor.
Occipital Neuralgia Exercises
If you’re looking for other ways to get occipital neuralgia relief at home, here are some exercises that, by their design, help relieve the pain of occipital neuralgia.
Occipital Neck Stretch
- First, find a straight-back chair.
- Sit in it and keep your head and neck in alignment with your spine.
- Next, put your right-hand middle and pointer finger on your chin, and push the chin back gently while keeping your mouth closed.
- Then, gently move your head backwards.
- You will feel relieving sensations as you stretch backwards and hold for a brief moment and release.
Rotation of the Neck
- Sit or stand with your head and neck in line with your spine.
- Keep your head straight and slowly rotate your head to the right and hold for a few moments, then release.
- Repeat with the left side.
Extend and Flex the Neck
- Rest your hands on your knees while sitting.
- Keep your head and neck in line with your spine.
- Next, while looking forward, slowly lean your head back.
- Then, slowly bring your head to the upright position.
- Finally, bend your head forward slowly until your chin touches your chest (or as far as you are able).
- Repeat 5 to 10 times per session.
Savasana Yoga Pose
- Find a pillow or blanket that allows your head and neck to be in alignment. In other words, keep the head at the same level as the neck on your pillow.
- Rest your legs in a natural position with your arms out to the side with palms facing up.
- Maintain this relaxing pose for about 30 minutes.
Tip o’ the Hat to LiveStrong.
Occipital neuralgia is a severe pain that stems from pressure, inflammation, and other causes in the back of the head and neck. It sometimes feels like an electrical shock or sharp stabbing pain. There are many occipital neuralgia symptoms, so be sure to keep a diary of symptoms for your medical professional.
Furthermore, there are treatments your doctor can administer to relieve this type of pain. You may also include home treatment, with the right diet and exercise, to relieve your occipital neuralgia symptoms.
In closing, remember to keep your pain diary to better keep both you, and your doctor, informed of your progress and symptoms. Also, continue to do your research to be aware of the latest findings regarding the causes, diagnosis, and treatment of occipital neuralgia.
These statements have not been evaluated by the Food and Drug Administration. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.