Have you ever experienced a stabbing sensation or pain like an electric shock at the base of your skull that radiates upward? If this happens often, it may be an intense and unsettling type of headache called occipital neuralgia. This chronic headache disorder causes sharp pain in the upper neck, back of the head and sometimes behind the eye. Occipital nerve irritation results in pain that can mimic a migraine, but the cause and treatment are quite different.
Occipital neuralgia can cause severe pain and disrupt your quality of life—but you don’t have to live with it forever. If you’re experiencing sharp pain in the upper neck or scalp that doesn’t respond to over-the-counter remedies and you’re in the Minneapolis/St. Paul area, the spine specialists at Summit Orthopedics can help determine whether occipital neuralgia is the cause and develop a personalized care plan.
What Triggers Occipital Neuralgia Pain
“Occipital” refers to the bone at the back of the skull. This region contains the greater and lesser occipital nerves that pass through muscles in the scalp. When these nerves become irritated, they can block pain messages from being processed normally. Instead, the nerves send shocking pain signals. This type of nerve condition is called neuralgia.
Occipital neuralgia pain can be aching or throbbing, may feel sharp, shooting or almost electric, and it can cause tenderness in the scalp. It usually starts in the upper neck and spreads upward across the back or one or both sides of the scalp. Other types of neuralgia start in different areas of the body.
Irritation of the occipital nerve can occur for many reasons, but it’s often related to:
- Cervical disc disease
- Cervical radiculopathy
- Inflammation
- Muscle tension
- Osteoarthritis of the upper cervical spine
- Trauma or injury
Symptoms of Occipital Neuralgia
Occipital neuralgia may seem like a standard headache at first, but certain signs can help differentiate it from other headache disorders. Common symptoms of occipital neuralgia include:
- Extreme scalp sensitivity
- Migraine-type headache with sharp, stabbing pain
- Pain on either side of the head and behind the eye
- Pain that starts at the base of the head and travels up the scalp
- Pain with neck motion
If you’ve ever experienced migraine pain, you’ll recognize many of these symptoms.
Occipital Neuralgia Diagnosis
Because occipital neuralgia can resemble other headache disorders, your provider will perform a thorough physical examination and review your medical history to rule out other causes.
There is no single test for occipital neuralgia, but one of the most effective tools for diagnosis is an occipital nerve block. During this procedure, your provider injects a local anesthetic around the affected nerves. If your pain significantly decreases after the injection, it confirms that the occipital nerves are the source of your symptoms. This helps ensure that your treatment targets the true cause of your pain.
In some cases, your provider may conduct diagnostic imaging studies such as MRI or CT scans to check for structural issues, such as pinched nerves or spinal abnormalities.
Nonsurgical Occipital Neuralgia Treatment
Fortunately, there are many ways to manage and relieve occipital neuralgia pain. Treatment starts with conservative methods and progresses to more advanced options or even surgical treatments if symptoms persist. Nonsurgical treatment options for occipital neuralgia include:
- Heat and cold therapy. Heat and cold therapy provide temporary occipital neuralgia relief by using heat to relax tense muscles or using cold to numb pain or reduce inflammation.
- Injections. An injection of a combination of anesthetic and sometimes steroids near the occipital nerves may alleviate pain by reducing swelling and inflammation.
- Medications. Pain relievers, anti-inflammatory drugs, muscle relaxants and sometimes anticonvulsants or antidepressants can occipital neuralgia pain, reduce inflammation and relax muscle tension. Muscle relaxants alleviate muscle spasticity and reducing muscle tension, which help relieve pain associated with occipital neuralgia.
- Occipital nerve blocks[JH1] . An injection of a combination of anesthetic and steroids near the occipital nerves helps alleviate pain, reduce inflammation and address nerve irritation
- Physical therapy. Using techniques such as manual therapy, stretching and posture correction, physical therapy can help alleviate pain, reduce muscle tension and improve overall function.
Surgical Occipital Neuralgia Treatment
If your symptoms don’t improve with conservative care, your provider may recommend surgical treatments. Surgery is usually reserved for chronic, severe cases where pain significantly interferes with daily life. Surgical options include:
- Nerve decompression or neurectomy. Nerve decompression or neurectomy treats occipital neuralgia by surgically relieving pressure on the occipital nerves or removing part of the affected nerve to reduce irritation, pain and associated symptoms.
- Occipital release surgery. Occipital release surgery treats occipital neuralgia by decompressing or removing pressure from the occipital nerves, often by severing surrounding tissues or structures.
- Spinal cord stimulation (SCS). An implanted device delivers electrical pulses to the spinal cord, which interferes with pain signal transmission and provides chronic nerve pain relief.
Does Occipital Neuralgia Ever Go Away?
For some people, occipital neuralgia can be temporary—especially if it results from irritation from muscle tension or a minor injury. With proper rest, posture correction and physical therapy, the symptoms can subside.
However, in cases like those involving irritation caused by nerve compression or underlying spine issues, occipital neuralgia may become a long-term condition. That said, many people still find significant relief through a combination of treatment approaches, including nerve blocks, medications, physical therapy and, if needed, occipital release surgery or spinal cord stimulation.
The sooner you treat the underlying cause of nerve irritation, the more likely you are to prevent chronic pain. The team at Summit Orthopedics can help you find a treatment that works.
Finding Relief for Neck and Nerve Pain
At Summit Orthopedics, our comprehensive spine expertise extends into neck and head conditions like occipital neuralgia. We create custom treatment plans starting with a conservative, nonsurgical approach using medications, injections, specialized physical therapy and activity modifications to help you find relief. If needed, our highly skilled surgeons can help you explore more options.
Summit Orthopedics has nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics spine expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
