Occipital neuralgia is a medical condition characterized by chronic headaches, pain in the upper neck, back of the head, and behind the eyes. And while the American Migraine Foundation classifies it as a rare condition, it is still quite common among people.
The locations where you feel pain correspond to the locations of the lesser and greater occipital nerves.The rare type of a chronic headache disorder occurs when pain stems from the occipital region and then spreads through the occipital nerves. These nerves run from the top of your spinal cord to your scalp.
The difference between occipital neuralgia and headaches and migraines is that the former can be triggered quickly.In some cases, even a simple touch, for example, brushing your hair, can cause the pain.
Attacks are usually brief and come with intense and sharp pain lasting only for a few seconds or few minutes. On the other side, migraine pan can last much longer. According to statistics, 3 out of every 100,000 people suffer from the condition on a yearly basis.
Symptoms of occipital neuralgia
As mentioned previously, the primary symptom of the condition is a sudden and severe pain. Many people associate the pain with a migraine. However, if the pain goes away in a minute or two, it is not a migraine.
Some people describe the pain as intense and piercing, others like stabbing and sharp, but the episodes last only for a few minutes. Symptoms of the rare condition vary from one person to another. However, most of the patients will experience pain along the neck where it meets the skull, and along the back of the head.
The pain can be one-sided or located on both sides of your head. In some cases, the pain feels like an electric shock along the nerve, or be sharp and stabbing.Rarely, the pain is dull aching or throbbing. Pain can travel as far as the forehead, but always starts at same places and moves along the side of the head.
Some other symptoms include:
- Migraine-like symptoms like sensitivity to light and sensitivity to sound
- Scalp tenderness
- Increased pain when moving the neck
- Watering eye
- Eye redness
- Pain in the neck
It is important that you recognize the symptoms, most importantly, the type of pain you are feeling. Pain in the neck can be sometimes caused by other disorders.
Structures located within the neck include neck muscles, arteries, veins, lymph glands, thyroid gland, esophagus, larynx, and parathyroid glands.
Anyone of these can be causing pain, but none causes sharp and intense pain that goes away within minutes.
What causes occipital neuralgia?
Occipital neuralgia is most commonly caused by pinched nerves in the root of a person’s neck. Sometimes this is caused by muscles that are too tight in a person’s neck. In some cases, it can be caused by a head or neck injury. Chronic neck tension is another common cause.
Other conditions that can lead or contribute to causes of occipital neuralgia include:
- osteoarthritis, especially of the upper cervical spine, which can pinch nerves
- tumors affecting nerve roots
- blood vessel inflammation
Individual attacks or episodes of occipital neuralgia can occur seemingly spontaneously, or be triggered by a light touch.
How is occipital neuralgia diagnosed?
When you make an appointment with your doctor, they’ll first ask about your medical history. They’ll ask how long you’ve experienced symptoms, and may ask questions to look for underlying conditions. During the physical exam, if they suspect occipital neuralgia instead of headaches or migraines, they’ll press on the occipital regions to see if you experience pain as a result.
To rule out other conditions and to search for the underlying cause of occipital neuralgia, your doctor may order additional imaging tests like an MRI or a CT scan. This will help them look at your spine, and search for different causes of the pain. In most cases, neurologic exams will come back with no abnormalities from the neuralgia alone.
What are the treatment options?
There are several treatment options that you can try for occipital neuralgia.
To start, doctors usually recommend trying home treatment, which is as simple as applying warm compresses to the affected area.
Your physician in some cases can recommend physical therapy, prescription muscle relaxers, or massage. All of this help treat the pinched nerves caused by tight muscles.
If conservative methods do not yield results, doctors can inject a local anesthetic to your occipital area, which provides immediate relief.
These anesthetics can last up to 12 weeks. In some rare cases, if the cause is just too serious, doctors recommend surgery to decrease pressure on the nerves.
Can you cure it?
For most patients, conservative therapy or nerve blockers are effective in relieving pain. For others, a more invasive therapy is needed, but it is successful nevertheless.
The response to treatment can vary from one person to another. The good news is that the headache does not lead to other neurological conditions or nerve problems.
Can you prevent it?
The problem with this type of a headache is that the cause is not found. Therefore, it is difficult to determine how to prevent it.
However, recognizing and identifying the factors causing and contributing to muscle tension will help.