Occipital neuralgia is a form of headache originating in the occipital nerves, which extend from the upper neck to the rear and top of the head. It has a number of potential causes, including pinched nerves, direct trauma, diabetes, gout, infection and blood vessel inflammation. It may also occur without a known cause. Treatment or cure for occipital neuralgia involves alleviation of symptoms, as well as resolution of any underlying conditions.
Identifying Occipital Neuralgia
According to the National Institute of Neurological Disorders and Stroke, if you suffer from occipital neuralgia, you will likely experience a constant throbbing pain that radiates from one side of your neck to the back of your head and behind your ear. Your symptoms may also affect both sides of your head, or extend to your forehead, scalp or the region behind your eyes. Typically, your pain levels will worsen intermittently, causing a shocking or piercing sensation. In some cases, moving your neck or brushing your hair will worsen your symptoms. If you experience these signs, see your doctor for a proper diagnosis.
In many respects, the symptoms of occipital neuralgia mimic other common forms of head pain, including migraine and cluster headaches. To properly diagnose your condition, your doctor may perform a temporary procedure called a percutaneous nerve block, which involves injecting a small amount of local anesthetic under the skin near your occipital nerves. If this injection is successful in relieving your pain, occipital neuralgia is identified as the source of your problems.
Typically, treatment for occipital neuralgia begins with conservative methods designed to diminish or alleviate your pain. Common methods include simple rest and the periodic application of a heat source to the affected area. You may also be treated with physical therapy and massage, as well as anti-inflammatory medications or muscle relaxants. Additionally, your doctor may choose to address your pain through use of antidepressants, or anti-convulsant medications such as gabapentin or carbamazepine.
In many cases, the combination of these approaches is sufficient to bring partial or total pain relief. However, if your pain persists, your doctor may choose to continue treatment with percutaneous nerve blocks, either of the occipital nerves themselves or of the nerve roots at your C2 or C3 neck vertebrae. If this is the case, local anesthetic will be combined with an anti-inflammatory steroid compound. The ongoing effectiveness of this technique requires repeated injections of these medications, and you should be aware that potential side effects of repeated use include fluid retention, muscle weakness and intermittent hypertension.
If your pain is chronic or severe, your doctor may consider surgical methods of symptom relief. Microvascular decompression is a technique that involves identifying and slightly relocating any blood vessels that may be intruding upon your nerves. Occipital nerve stimulation involves placing lead wires under the skin that transmit electrical impulses to block pain messages sent by your brain. These procedures carry some risk of permanent nerve injury, and you should consult your surgeon prior to treatment.