Occipital Neuralgia

Occipital Neuralgia

Often mistaken for migraine or other similar types of headaches, occipital neuralgia occurs as a result of inflammation or injury occurring in the occipital nerves. The two occipital nerves originate at the top of the spinal cord and run up through the scalp; when occipital neuralgia is present, there will be pain in the back of the head, the neck, and at the base of the skull.

Common Causes of Occipital Neuralgia

Occipital neuralgia occurs as a result of inflammation, pressure, or injury on or around the occipital nerves. While doctors often have difficulty determining a direct cause, there are some medical conditions that have been associated with occipital neuralgia, including:

  • Injury or trauma to the neck or back of the head;
  • Muscle tension or muscle spasms in the neck;
  • Osteoarthritis;
  • Tumors in the neck;
  • Cervical disc disease;
  • Infection;
  • Diabetes.


Symptoms of occipital neuralgia are very similar to those associated with migraines; these similarities in symptoms often means that occipital neuralgia goes undiagnosed and untreated.

Symptoms of occipital neuralgia range from mild to severe, and can include:


Sharp, intense pain, often described as “jabbing” or “shock-like”, in the back of the head and at the base of the skull


Throbbing, aching, or burning discomfort starting at the base of the skull and radiating upward and toward the scalp


Sharp, shooting pain on one or both sides of the head


Pain behind one or both eyes


Sensitivity to light


Pain in neck when turning or rotating the head


It is often difficult to determine if the pain and discomfort is a result of occipital neuralgia or from another type of headache; your doctor will conduct a thorough physical examination, assess your medical history, and most likely order a series of diagnostic and imaging tests in an attempt to determine the cause of your headaches and discomfort.

As part of assessing your condition, your doctor may also inject a nerve-blocking agent to better determine if occipital neuralgia is causing the pain and discomfort.

Possible Treatments

While most cases of occipital neuralgia respond to the above treatment, there are rare cases where surgery must be performed to correct the condition, specifically:

  • Microvascular decompression, as a way of relieving pressure and eliminating pain by adjusting the blood vessels compressing the nerve in the afflicted area.
  • Nerve stimulation, or using an electrical pulse delivered to the occipital nerve by a neurostimulator as a way to block messages of pain and discomfort from being delivered to the brain.

While an intense and painful condition, occipital neuralgia is not typically a chronic and/or life-threatening condition. Most patients notice significant improvement in the condition after a week to 10-days of self-care, rest, and medication (if prescribed). However, like any condition that causes you pain or discomfort, you should work with your physician to properly diagnose and treat the condition.

Treatment for occipital neuralgia often begins as self-care, and includes:


Resting in a dark, quiet room
Applying a gentle heat source to the head and/or neck
Massaging the afflicted area
OTC pain relievers
Prescription medications to relax the muscles
Nerve blocks
Steroid injection to alleviate inflammation around the occipital nerves
Dr.Raju Mantena
Dr. Raju Mantena is an anesthesiologist and pain specialist based in the Houston area and has over 15 years of medical experience which he relies upon each day to successfully treat his patients’ acute and chronic pain.

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I’ve had terrible migraines for as long as I can remember, and nothing seemed to work. A friend of mine turned me on to Dr. Mantena and I’m so grateful she did. It’s been almost two months, and I haven’t had even one migraine in that time. I was getting them every week before, so this is amazing. A big thanks to Dr. Mantena

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