Massage for Occipital Neuralgia

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.



Greater. Occipital nerves. Occipital neuralgia is a type of chronic headache disorder. It occurs when pain stems from the occipital region and spread through the occipital nerves. The occipital nerves run from the top of your spinal cord to your scalp. Trapezius muscle.

  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
Hot spots of pain due to greater occipital nerve. Supraorbital. Temporal. Tempero-mandibular. The angle of the jaw. Sternocleidomastoid. Supraclavicular.

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.  


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


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.

What massage is best for occipital neuralgia?
Apply gentle pressure from your fingertips at the base of your skull. This massage can help calm tight muscles and release tension. You can also place a rolled towel under your head and neck as you lie down on your back. The pressure from the towel can provide a gentle massage.
What is the fastest way to cure occipital neuralgia?
  1. Apply heat to your neck.
  2. Rest in a quiet room.
  3. Massage tight and painful neck muscles.
  4. Take over-the-counter anti-inflammatory drugs, like naproxen or ibuprofen.
How do you release the occipital nerve?
Surgical options include occipital release surgery. In this outpatient procedure, your doctor makes an incision in the back of the neck to expose your occipital nerves and release them from the surrounding connective tissue and muscles that may be compressing them.
Can you massage 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.
What do occipital nerves do?
The greater occipital nerve arises between the first and second cervical vertebrae, along with the lesser occipital nerve. It supplies sensation to the skin along the back of the scalp to the top of the head.
What aggravates occipital neuralgia?
If your occipital nerves are already inflamed or irritated, touching the back of your head or neck may trigger occipital neuralgia. Even brushing your hair or bumping your head against a headrest may trigger it.
What triggers occipital neuralgia?
 Occipital neuralgia may occur spontaneously, or as the result of a pinched nerve root in the neck (from arthritis, for example), or because of prior injury or surgery to the scalp or skull. Sometimes “tight” muscles at the back of the head can entrap the nerves.
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.
Does occipital neuralgia get worse with exercise?
During organized exercise or other physical exertion, some people will have sudden, severe pain in the occipital area (headache at the top of the neck and base of the skull).
Can occipital neuralgia be reversed?
Although a specific cure for occipital neuralgia does not exist, there are many effective symptomatic treatment options.
What mimics occipital neuralgia?
Tension-type headache, which is much more common, occasionally mimics the pain of occipital neuralgia.
Why does occipital neuralgia get worse at night?
Failing to get adequate sleep and sleeping in the wrong position can intensify the pain. In fact, sleeping with a poor posture is a top cause of occipital neuralgia. People say they wake up with a stiff neck, which means a muscle is strained and nerves inflamed.
Can occipital neuralgia cause a stroke?
In some cases, occipital neuralgia symptoms may actually indicate a life-threatening stroke. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening sudden symptoms including Abnormal pupil size or nonreactivity to light.
Can magnesium help occipital neuralgia?
Because of the inflammatory process associated with occipital neuralgia, anti-inflammatory nutrients can be beneficial for patients who suffer from this type of headache. Calcium/magnesium supplements are most commonly used for their overall anti-inflammatory properties.
Will a brain MRI show occipital neuralgia?
Radiographic imaging is of limited utility in the diagnosis of occipital neuralgia but is primarily concerned with excluding structural pathology of the cord, the spine, the occipital nerves, or adjacent structures. As such, MRI is best suited to this task.
Do neurologists treat occipital neuralgia?
Yes. Pinching or irritation of occipital nerves can trigger headaches or migraines. If you are experiencing severe or persistent headaches, it is recommended that you visit a neurologist or head and neck specialist to receive a proper diagnosis,
Can you live a normal life with occipital neuralgia?
While an intense and painful condition, occipital neuralgia is not typically a chronic and/or life-threatening condition. Most patients notice a significant improvement in the condition after a week to 10-days of self-care, rest, and medication (if prescribed).

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.

Can tight occipital muscles cause dizziness?
 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.
Does occipital neuralgia affect vision?
 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.
Can occipital neuralgia be caused by stress?
 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).
How does occipital nerve stimulation work?
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.
Is occipital neuralgia a type of migraine?
 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.
What type of nerve is the occipital nerve?
 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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