Occipital neuralgia is a headache with pain that starts in the back of the neck or head and moves to the scalp. It happens due to a problem with the two occipital nerves in the neck.
The exact cause is not always known. Other times it may be due to injury or irritation of the nerve from problems like:
Things that may raise the chance of occipital neuralgia are:
The main problem is pain that starts in the back of the neck or head and moves up the scalp. It may be sudden, sharp, burning, or throbbing. The area may also feel numb. How long it lasts differs in each person.
The doctor will ask about your symptoms and health history. A physical exam will be done. A neurological exam may also be done.
Images may be taken of the head and neck. This can be done with:
An occipital nerve block may be done. A needle with numbing medicine is inserted near the nerve. If it relieves pain, then the nerve is likely the cause of the problem.
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The goal of treatment is to ease or stop pain. Any underlying causes will also need to be treated.
For most, neuralgia can be relieved with:
Medicines that may help ease pain are:
A nerve block or corticosteroid injections may also be given. A nerve block stops the nerve from sending pain signals. A corticosteroid can ease pressure on the nerve.
People with severe symptoms may need surgery, such as:
Not all causes of occipital neuralgia can be prevented. Exercising the muscles of the neck may help.
American Association of Neurological Surgeons
National Institute of Neurological Disorders and Stroke
Canadian Neurosurgical Society
Public Health Agency of Canada
Headache—approach to the adult patient. EBSCO DynaMed website. Available at:https://www.dynamed.com/approach-to/headache-approach-to-the-adult-patient#TOPIC_IRG_HHZ_TKB. Updated November 28, 2018. Accessed April 24, 2020.
Occipital neuralgia. American Association of Neurological Surgeons website. Available at: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Occiptal%20Neuralgia.aspx. Accessed April 24, 2020.
Occipital neuraglia. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/nervous_system_disorders/Occipital_Neuralgia_22,OccipitalNeuralgia. Accessed April 24, 2020.
Occipital neuralgia information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Occipital-Neuralgia-Information-Page. Updated March 27, 2019. Accessed April 24, 2020.
Therapeutic pain blocks. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/headache/procedures/greater_occipital_nerve_block.html. Accessed April 24, 2020.
Last reviewed February 2020 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 4/24/2020