Occipital Neuralgia: Healing Horrible Headaches?

After many years of headache pain, I recently learned from my neurologist that much of what I thought to be migraine is due to occipital neuralgia. Aside from her recommendation for muscle relaxants and yoga, what would you recommend?

– April 19, 2010

Occipital neuralgia causes piercing, throbbing, or electric-shock-like pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. The pain typically begins in the neck and then spreads upwards. Some people also experience pain in the scalp, forehead, and behind the eyes. The scalp may even be tender to the touch, and the eyes especially sensitive to light.

The location of pain is related to areas of the head and neck served by the occipital nerves, which extend from the area where the spinal column meets the neck, up to the scalp at the back of the head. The pain stems from irritation or injury to these nerves that can be due to trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it exits the spine due to osteoarthritis, or tumors or other types of lesions in the neck. Localized inflammation or infection, gout, diabetes and blood vessel inflammation (vasculitis) are also associated with occipital neuralgia, as is habitually keeping the head in a downward and forward position for long stretches at a time. Often, however, no cause can be found.

In addition to the muscle relaxants and yoga recommended by your physician, conventional treatment often includes massage and rest. My recommendation would be cranial osteopathy, an osteopathic manipulative technique that I’ve found extremely useful for a wide range of problems, from headaches to hyperactivity in children, disturbed sleep cycles and asthma. Cranial osteopathy works through very gentle pressure applied with the hands to the head. The aim is to free up restrictions in the movement of the cranial bones and allow the subtle natural rhythms of the central nervous system to express themselves in a balanced fashion. The American Academy of Osteopathy maintains a list of physicians trained in osteopathic manipulation.

Andrew Weil, M.D.

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