Occipital Neuralgia

Occipital neuralgia may be caused by injury to or irritation of the occipital nerves. It may be the result of underlying trauma, such as a head injury or nerve inflammation or compression. Nerve compression can be caused by prolonged tightness of the neck muscles, osteoarthritis in the neck or a tumor growing near the nerve. In addition, conditions that may cause occipital neuralgia may include:

⦿ Diabetes

⦿ Infection

⦿ Vasculitis

⦿ Gout

Posture issues may also cause occipital neuralgia if the patient’s head is often held forward and down, as this position can place excessive pressure on the nerve over time. In some cases, however, the exact cause of cause is never determined.

Patients suffering from occipital neuralgia may experience:

⦿ Tenderness in the scalp

⦿ Pain when moving the neck

⦿ Pain radiating from the base of the head to the scalp

⦿ Sensitivity to light

For some patients, the pain may spread across the scalp and extend as far as reaching the forehead and eyes. This chronic condition often produces pain that has a severe shooting or throbbing quality.

The scalp may become so uncomfortable and the symptoms so easily triggered, that even such simple activities as leaning against a headrest or brushing hair, cause extreme pain.

Occipital neuralgia is diagnosed after a medical history is taken and a physical examination is conducted. Additional tests, including an MRI scan or a blood test may be performed. In addition, a nerve block, in which an anesthetic is injected into the occipital nerve, is often performed for diagnostic reasons. If this procedure provides the patient with significant symptom relief, it is considered a confirmation of the occipital neuralgia diagnosis, because it definitively indicates that the nerve is the source of the pain.

Treatment for occipital neuralgia may include may include conservative measures to relieve discomfort which may include:

⦿ Rest

⦿ Massage

⦿ Over-the-counter pain medication

⦿ Anti-inflammatory medications

In some cases, prescription medicines such as antidepressants or muscle relaxants can also be effective. If the pain does not respond to these treatments, occipital nerve blocks may be used to reduce inflammation and provide pain relief in the area. This minimally invasive treatment option uses corticosteroids that are injected directly into the affected nerve. The effectiveness of occipital nerve blocks varies from patient to patient, and pain relief may last anywhere from a few days to a few months.

In he most severe cases, surgery may be necessary to remove tissue or trim away parts of the bone or muscles that are compressing the nerve. Occipital nerve stimulation may also be an option for some patients. In this procedure, a neurostimulator is used to deliver electrical impulses to the occipital nerves, which help to stop the nerve from sending signals of pain to the brain.