The tension in the upper trapezius can compress the greater occipital nerve, resulting in Greater Occipital Nerve Neuralgia. Symptoms are a dull, drilling pain in the morning in the occipital area, neck, and shoulders. The neck is stiff and uncomfortable. Pain is normally felt on one side of the head. There is no aura, distinguishing this headache from a migraine. Pain can be local or radiate to the forehead.
In other cases, the temporal artery is constricted due to the tension of the upper trapezius muscle. When this occurs, it results in an acute vascular headache or migraine. This headache is much more severe than one from just an active trigger point and affects half the head and eye.
Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.
If you have painful, chronic headaches that tend to originate at the back of your head, you should get checked out for occipital neuralgia. This condition is sometimes confused with migraines or tension headaches since overlapping symptoms exist. Read on to learn more about occipital neuralgia and how to treat it. What Is Occipital Neuralgia? At the back of your head, you have a trapezoidal-shaped bone called the occipital bone. The nerves that run through this area are called the occipital nerves. Sometimes, these nerves can become inflamed or injured, thus causing occipital neuralgia. Neuralgia is pain that follows the path of a damaged nerve. This pain often feels like a sharp electrical shock. Other symptoms of occipital neuralgia include:
- A tender scalp
- Sensitivity to light
- Pain when you move your head
- Pain behind your eyes
- Burning or throbbing pain that originates at the base of your skull
If you have any of these symptoms, speak to your doctor. What Causes It and How Is It Diagnosed? Many causes of occipital neuralgia exist. You could have a pre-existing medical condition, like diabetes, that could make you more prone to developing occipital neuralgia. Inflammatory conditions, like gout or osteoarthritis, can also cause occipital neuralgia as a side effect. If you are stressed or hold tension in your back or neck, you could also develop occipital neuralgia. Injuries, like whiplash, can strain the supporting tissues in your neck and head, thus increasing the risk of nerve inflammation. Even if you have most of these symptoms, you should get checked out by a pain management clinic to confirm the diagnosis since, again, occipital neuralgia can have similar symptoms to other conditions. A doctor will likely perform a physical exam to see if the back of your head is tender. He or she may also give you a shot to numb the irritated nerves. If you find relief with a numbing agent to nerves behind your neck and around the base of your skull, then occipital neuralgia is a likely cause of your symptoms. How Can You Manage the Pain of Occipital Neuralgia? If the occipital neuralgia is from an injury, then massage therapy, physical therapy, and rest may be the only things necessary for a full recovery. However, if occipital neuralgia is from a secondary condition, you may need to find other ways to manage your pain. Learn about just a few things you can try that may help. Nerve Block Injections Some pain clinics offer regular sessions for nerve block injections. These injections contain a long-acting anesthetic and a steroidal anti-inflammatory medication. The goal of these injections is to interrupt or block the pain signals that travel up the nerves. You may experience temporary discomfort during the injections, but this should pass as the medications start working. While every patient is different, a nerve block injection could manage your pain for a few days, weeks, or months. Botox Injections You may already know that Botox can be used for migraines, but it can also be used for pain related to occipital neuralgia. One study showed that while Botox didn’t help participants with pins-and-needles pain or dull pain, it did help participants with sharp/shooting type pain that is common in occipital neuralgia. Spinal Decompression If you aren’t keen on injections, you may want to consider cervical decompression. Occipital nerve inflammation could be from nerve compression. During spinal decompression, a pain clinic professional or chiropractor can gently adjust your cervical spine to reduce pressure.
Symptoms
Occipital neuralgia can cause intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms include:
- Aching, burning, and throbbing pain that typically starts at the base of the head and goes to the scalp
- Pain on one or both sides of the head
- Pain behind the eye
- Sensitivity to light
- Tender scalp
- Pain when you move your neck
Causes
Occipital neuralgia happens when there’s pressure or irritation to your occipital nerves, maybe because of an injury, tight muscles that entrap the nerves, or inflammation. Many times, doctors can’t find a cause for it.
Some medical conditions are linked to it, including:
- Trauma to the back of the head
- Neck tension or tight neck muscles
- Osteoarthritis
- Tumors in the neck
- Cervical disc disease
- Infection
- Gout
- Diabetes
- Blood vessel inflammation
How It’s Diagnosed
Your doctor will ask you questions about your medical history and about any injuries you’ve had. They’ll do a physical exam, too. They’ll press firmly around the back of your head to see if they can reproduce your pain.
They may also give you a shot to numb the nerve, called a nerve block, to see if it gives you relief. If it works, occipital neuralgia is likely the cause of the pain. You might also have blood tests or an MRI scan if your doctor thinks your case isn’t typical.
You have to get the right diagnosis to get the right treatment. For example, if you have occipital neuralgia and you get a prescription for migraine medication, you may not get relief.
Benefits of Massage for Occipital Neuralgia
Massage can be an effective way to relieve symptoms of occipital neuralgia, especially if from tight muscles. If your neck muscles are tight, they may cause entrapment of your nerve. During a massage session, your massage therapist will focus on these trigger points to help release any entrapment.
- Apply heat to your neck.
- Rest in a quiet room.
- Massage tight and painful neck muscles.
- Take over-the-counter anti-inflammatory drugs, like naproxen or ibuprofen.
How do you strengthen the occipital muscle?
To train the occipital muscles, lie on a table, on your back. Begin with the back of your head against the table. Slowly press the back of the head into the table, creating a double chin. Complete eight to 12 repetitions, one to three times per day.
We can see how irritation of these peripheral occipital nerves found in the muscles of the neck and in the back of the head may be caused not only headache pain, but dizziness, and balance issues as well.
This pain is typically one-sided, although it can be on both sides if both occipital nerves have been affected. Additionally, the pain may radiate forward toward the eye, as it follows the path of the occipital nerve(s). Individuals may notice blurred vision as the pain radiates near or behind the eye.
Occipital neuralgia is caused by damage to the occipital nerves, which can arise from trauma (usually concussive or cervical), physical stress on the nerve, repetitive neck contraction, flexion or extension, and/or as a result of medical complications (such as osteochondroma, a benign bone tumor).
In occipital nerve stimulation, your doctor implants a small device at the base of the skull with leads connected to a power source (pulse generator) that sends electrical impulses to the occipital nerve.
The pain may be felt at the back of your head or the base of your skull. Occipital neuralgia is very similar to migraines in that some of the symptoms are the same. However, caring for these conditions is very different, and it is important to get the proper diagnosis from your doctor.
The greater occipital nerve is a cutaneous nerve, the thickest in the body, that innervates the skin from the upper neck, over the occiput, up to the vertex of the scalp.
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