What Are Occipital Neuralgia Headaches?
Occipital neuralgia headaches stem from injury or inflammation affecting the two occipital nerves, which travel from the top of the spinal cord up through the scalp along opposite sides of the head. These nerves transmit most of the feeling in the head to the brain.
What Are The Symptoms Of Occipital Neuralgia?
Occipital neuralgia can cause piercing, throbbing, or electric-shock-like chronic pain in the upper neck and back of the head, usually on one side. The pain typically begins in the neck and spreads upwards. Some people also experience pain in the scalp, forehead, and behind the ears, and the eyes may become especially sensitive to light. In some cases, neck movements trigger pain and the scalp may be tender to the touch.
These headaches are considered relatively rare and difficult to diagnose. Tenderness in response to pressure along the occipital nerves may help lead to a diagnosis. Pain that resolves with administration of an occipital nerve block (see Conventional Treatment below) can confirm a diagnosis.
What Are The Causes Of Occipital Neuralgia?
The irritation or injury that causes the pain of occipital neuralgia can stem from trauma to the back of the head, pinching of the nerves by overly tight neck muscles, or compression of the nerve as it exits the spine due to osteoarthritis, 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 extended periods of time. Often, however, no cause can be found.
Prevention Of Occipital Neuralgia
Rest, massage and warm compresses can help relieve the pain of occipital neuralgia and may ease the pressure on the nerve. Physical therapy can teach you exercises that may help prevent the headaches.
Conventional Treatment Of Occipital Neuralgia
Treatment may include heat, rest and physical therapy as well as massage, and anti-inflammatory medications and muscle relaxants. Anticonvulsant drugs may also be prescribed as may antidepressants in severe cases. If these methods fail, surgery may be recommended to relieve pressure on the affected nerves.
A less invasive option is use of a nerve block to prevent pain signals from the nerves from reaching the brain. These blocks involve the injection of a solution usually containing a long-acting local anesthetic and a steroid anti-inflammatory drug. The infusion itself may be somewhat uncomfortable, but pain relief often occurs within 15 minutes and can last for a few days to weeks and even months. Sometimes the pain doesn’t recur at all. Complications of nerve blocks are considered rare when the procedure is performed by an experienced provider. After-effects may include some temporary numbness in the regions of the scalp and head supplied by the nerves and, sometimes, difficulty speaking or swallowing for a few hours.
What Does Dr. Weil Recommend For Occipital Neuralgia?
Dr. Weil recommends cranial osteopathy, an osteopathic manipulative technique that he has found extremely useful for a wide range of problems that may be caused or affected by small changes in the function anatomy of the skull, spine and central nervous system, 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 Cranial Academy maintains a list of physicians trained in this unique and useful therapy.
Carrie O. Dougherty, “Occipital neuralgia”, Current Pain and Headache Report, May, 2014. doi: 10.1007/s11916-014-0411-x.