Everything You Should know About Occipital Neuralgia

occipital neuralgia

In medical science neuralgia refers to the chronic pain in the nerves and Occipital Neuralgia is a medical condition in which person feels chronic pain in the locations of Occipital nerves. These nerves correspond to three main areas of the body including the back side of eyes and head, and upper neck. In some cases instead of feeling pain, the patient may feel nothing in the affected areas. This illness also goes by the names of Arnold’ Neuralgia and C2 Neuralgia. There are two kinds of occipital nerves; lesser and greater. Occipital artery wraps the greater occipital nerves and also contributes to the pain.

Symptoms of Occipital Neuralgia

The biggest symptom of this disease is the intense pain in head and upper neck. Some people confuse this disease with a general headache. The difference between occipital neuralgia and other types of headaches is that in the case of occipital neuralgia patient feels extreme jabbing like an electric shock on the back side of the head. This pain can reach to the back of the eyes and even to the eyebrows. Other symptoms of this disease include:

  • Burning of inner head

  • Severe throbbing in the region between the scalp and base of the head

  • Soreness of back neck

  • Difficulty in moving neck due to pain

  • Sensitivity to sound and light

  • Unclear speech

It is not necessary that every person suffering from this disease will have all these symptoms but the presence of some or most of these symptoms indicates that person is suffering from this disease.

Known Causes

Medically any kind of irritation and compression of occipital nerves leads to the occipital neuralgia. These disturbances in the occipital nerve can be caused by several reasons like head injury, inflammation of nerves, and entrapments of nerves due to heavy load on the back of the head. Labours who carry heavy load regularly on the back of their head and shoulder can face the entrapment and inflammation of nerves. Other causes of this disease include:

  • Tumour in the neck especially on the back side of the neck

  • Tightness of neck muscles due to any diseases or injury

  • Unusual spacing between C1 and C2 vertebrae

  • Disease of cervical disc

  • Interlocking of the occipital artery and greater occipital nerve

  • Inflammation of blood vessels

Besides these causes some diseases like diabetes, neck tension, and gout also lead to the occipital neuralgia. In short, anything that has the potential to inflame or compress the occipital nerve causes the occipital neuralgia.


Since some of the symptoms of occipital neuralgia are similar to that of other types of headaches, therefore, the diagnosis of this disease is very tricky. The inability of patients to identify the exact location of the pain also leads to the wrong diagnosis. To eliminate the risk of wrong diagnosis doctors asks about the history of the patient. If the patient has received a serious blow on the back of his head or carries heavy load regularly on this area then chances are high that patient is suffering from occipital neuroglia. The other, more reliable, method to diagnose this disease is the use of nerve block anaesthesia. If the patient feels relief in his pain after receiving the anaesthesia then it means pain is coming from the nerves. Doctors also suggest for the blood tests and MRI to make sure that pain is not coming from any other part of the body. MRI does not indicate the presence of pain but it can help doctors to identify any kind of abnormality in the occipital nerves or occipital artery. The diagnosis is very crucial for the treatment of this disease because the wrong diagnosis can change the course of treatment which can increase the severity of the disease.

Treatments for Occipital Neuralgia

Treatment of occipital neuralgia depends on its causes but in all cases first step is to reduce the pain of the patient. Treatment of this disease can be categorised into three categories; self-care treatment, medication, and surgery. There are several conventional but effective methods to get relief from this pain. These methods include

  • Application of heat to the back side of the head and neck. Hot water in the ice bags can be used for this purpose

  • Massaging of the affected area is also an effective solution to reduce the pain

  • Resting on a comfortable bed in calm environment releases pain

Somme anti-inflammatory drugs like ibuprofen and naproxen can be used to relieve pain but it is better to consult a doctor before taking any pill because it is almost impossible to diagnose occipital neuralgia at home. Doctors can also suggest one or more of the following medications

  • Gabapentin of Neurontin and carbamazepine of Tegretol because these are anticonvulsant drugs and developed to reduce nerve pain

  • Depression can further increase the pain, therefore, some doctors also suggest antidepressant as side medicine

  • Muscle relaxants to specifically reduce the pain in neck muscles

  • Steroid injection and nerve block. This is temporary treatment and should be used for a short time. It takes two or three injections to get the results but pain can come back anytime.

All these medications are effective but might not work in some cases. In some serious cases, surgery can also be used. There are two surgical methods to remove pain. In the first method, doctors adjust the blood vessels that are causing the compression of the nerve. This procedure is known as microvascular decompression. The other more advanced method is the use of electric pulses. Doctors use electric impulses to block the carriers that carry the pain messages. This method doesn’t bring nerves to its original shape but removes the pain. This treatment method requires special skills and equipment due to which every hospital can’t provide this treatment. The selection of treatment depends on the severity of illness and patient’s affordability and comfort. In some very rare cases occipital neuralgia can lead to cancer of the spine, therefore it is important to diagnose this disease in early stages and select the right treatment method.

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Spoonie Story: Leigh Ann

spoonie story leigh ann

I’m Leigh Ann and I have chronic migraine triggered by a condition called occipital neuralgia. I’ve had migraines since 2000, but they have progressively gotten worse over the years. I’ve tried everything out there to get relief, tried every medication, seen many doctors and more.

spoonie story leigh ann

In January, I was diagnosed with ON. I was glad to at least find the cause of my pain. I also found that I am a good candidate for a surgical procedure that could alleviate my pain, but my insurance refuses to cover any of it and I just don’t have that kind of money right now.

It sucks to be brought down by pain. Being told that I’m imagining it all, that it’s just a headache, that I need to control my body and force myself not to get them, that I need to just learn how to “live with the pain” all really hurt me. It’s depressing to not be taken seriously. You can’t measure pain and can’t see it. So that’s why it is another invisible illness.

I am thankful that I do have a husband and some family who actually do empathize and are compassionate. I cherish my good days. While they are few, I am thrilled to be on my game. When the bad days come, I try to fight it out and work through the pain. Sometimes I make it, other times I have to admit defeat for that day because the pain is too severe.

This year for Halloween I chose to be someone motivational. I’m sure we’ve all seen the posters from war time with the words “We can do it!” It give me hope and perhaps I can do it today. Maybe even tomorrow. I am grateful that I was able to take my son trick or treating this year. It meant a lot to me to be able to do that for him. Thanks for listening. ((hugs)) to all out there. We all need it.