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Head Pain: Occipital Neuralgia

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Occipital neuralgia involves the occipital nerves. There is one occipital nerve located on each side of the head, and it travels through muscles in the back of the head and up into the scalp, sometimes reaching as far as the forehead. The occipital nerves are responsible for feeling in the back and top of the head.

When occipital neuralgia occurs, irritation of the nerves can result in sudden pain that can be characterized as zapping, shooting, tingling, or electric. Sometimes, the pain radiates through surrounding areas and can contribute to numbness. These episodes are spontaneous and can be brought on by a simple act, such as lying on a pillow or brushing hair.

What causes occipital neuralgia?

The exact cause of occipital neuralgia is unknown. A pinched nerve in the neck, like from arthritis, or an injury can contribute. There is a difference between occipital neuralgia and migraines, but they can be hard to differentiate—so seeing a doctor is important for managing the pain.

Diagnosing occipital neuralgia involves a thorough history and physical examination. The doctor might diagnose the condition by pushing on certain areas of the head to see if it triggers a pain response.

How is occipital neuralgia treated?

Conservative approaches can be taken to manage pain episodes, like massages and warm compresses. Medications such as muscle relaxers can also be used. One of the most common approaches to managing occipital neuralgia is an occipital nerve block. This temporarily blocks the nerve so that it cannot send pain signals. The results from a nerve block can last up to 12 weeks.

A more permanent approach to managing occipital neuralgia is surgically decompressing the nerve by removing scar tissue or muscle. The nerve can also be cut or destroyed using radio-wave technology. This approach can lead to permanent numbness, so it is used as more of a last resort.