Recovery is usually complete after the bout of pain has ended and the nerve damage repaired or lessened. Skip to main content. Submit Search. You are here Home » Disorders » All Disorders. Occipital Neuralgia Information Page. What research is being done? See More About Research. Show More. Show Less. Search Disorders. Learn more. Most feeling in the back and top of the head is transmitted to the brain by the two greater occipital nerves. There is one nerve on each side of the head.
Emerging from between bones of the spine in the upper neck, the two greater occipital nerves make their way through muscles at the back of the head and into the scalp. They sometimes reach nearly as far forward as the forehead, but do not cover the face or the area near the ears; other nerves supply these regions. Irritation of one of these nerves anywhere along its course can cause a shooting, zapping, electric, or tingling pain very similar to that of trigeminal neuralgia , only with symptoms on one side of the scalp rather than in the face.
Sometimes the pain can also seem to shoot forward radiate toward one eye. In some patients the scalp becomes extremely sensitive to even the lightest touch, making washing the hair or lying on a pillow nearly impossible. In other patients there may be numbness in the affected area.
However, this will lead to scalp numbness. For example, chin tucks can help stretch and strengthen the neck muscles and other tissues. To do chin tucks:. When pulling the head back, keep the chin in a straight line, without lifting or tipping it. Do not continue if the exercise is painful. There are a few options that may help prevent occipital neuralgia.
These include anti-seizure medications and tricyclic antidepressants. Occipital neuralgia is a type of nerve pain that can lead to headaches. It can occur when there is pressure or damage to the occipital nerves. These start in the neck and run up the sides of the head. In most cases, the pain will improve with home remedies or medication. If the problem persists or recurs, however, a doctor may recommend injections or possibly surgery. Experts classify headaches by the type, location, and frequency of pain, as well as by the various causes.
Learn more and find a helpful chart here. Learn about some different primary and secondary headaches, including their causes and triggers. For each, we also examine the available treatment…. It is not uncommon to have a headache for days. Learn more. However, a reasonable case might also be made for MRI with soft tissue imaging of the neck, after trauma, looking for objective evidence of damage. Vascular imaging may be done to look for carotid or vertebral dissection or vascular compression.
This is extremely unlikely however and we don't recommend vascular imaging as a routine investigation. Occipital neuralgia can be extremely painful, and there are several treatment approaches. In general nerve blocks are used. Medications are usually not helpful for occipital neuralgia, but when ON is combined with migraine which is common , then it makes sense to treat both. Sahai-Srivastava et al, Blocks are injections of medication intended to temporarily deaden pain nerves.
They are ordinarily done by anesthesiologists in a pain clinic, or neurologists in a headache clinic. An example is shown above.
For occipital neuralgia, if the site of injury is the nerve itself such as when the nerve is bruised on the headrest of a car, the nerves should be blocked. The nerves have a fairly long course and several papers have been written concerning the optimal location to block e. Natsis et al, If the site of injury is one of the upper cervical nerve roots, then a more complex C2 cervical nerve block may need to be used.
This generally requires X-ray control. If a block works temporarily, it usually wears off as the anesthetic effect stops. To obtain a more lasting effect, a more permanent procedure is to damage the nerve. Here, partial nerve injury could make the nerve even more irritable, and complete nerve destruction could lead to denervation pain.
If the occipital nerve block doesn't work, it is likely that the pain is coming from somewhere else. We have encountered patients with cervical facet disease who have pain resembling ON. As the cervical facet nerve is closer to the spinal cord than the occipital nerve, blocking the occipital nerve leaves cervical facet pain untouched.
Similarly, an injury to the occipital nerves close to the spinal cord prior to emerging into the skull would be untouched by a peripheral occipital nerve block.
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