Occipital Neuralgia

Overview

The occipital nerves located along your neck and the back of your head receive sensations like temperature, touch and pressure for that area of your body. When they become damaged, you may feel a painful headache.

Symptoms

Occipital neuralgia pain typically feels piercing, throbbing or like an electric shock around your neck, the back of your head and behind your ear. It usually only affects one side of your head and that area may feel so sensitive to touch that even brushing your hair hurts. Similar to a migraine, with occipital neuralgia your eyes may become sensitive to light.

Causes

Damage to the occipital nerves might relate to a number of events or conditions, such as:

• Injury to the head/neck
• Tumors located along the spine
• Arthritis
• Infection
• Diabetes
• Stroke
• Blood vessel inflammation

Diagnosis

You may have difficulty distinguishing a cluster headache or migraine from occipital neuralgia. Keeping notes about your pain can help your physician make a more accurate diagnosis.

If tumors, bone damage or bleeding caused the occipital neuralgia, imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans can help provide an accurate diagnosis. Procedures that block nerve signals can also help verify the source of your pain.

Treatment

IU Health physicians can help you control the pain associated with occipital neuralgia. Your physician works with you to create a personalized treatment plan that fits your needs and improves your quality of life.

Fellowship-trained physicians at IU Health use the latest options and comprehensive services to help you find relief and cope with your chronic pain. A multidisciplinary team of pain management specialists, anesthesiology and neurology specialists, physical medicine physicians and nurses collaborate to address your treatment needs. Based on your medical history and personal preferences, they develop an individualized treatment plan suited to you.

IU Health physicians specialize in advanced therapies and administer a full range of treatment options for occipital neuralgia, including:

• Pain medicines. Medicines such as non-steroidal anti-inflammatory medicines (NSAIDs) or other prescription pain medicines may help control your pain from occipital neuralgia. Narcotic pain medicines do not effectively treat this pain. We work with you to find medicines with the fewest side effects that work best for you and your health.
• Antidepressants. Chronic pain can lead to depression and anxiety. In turn, these conditions may make chronic pain harder to treat. We may prescribe you antidepressants to improve your quality of life, as well as increase the effectiveness of your pain treatments.
• Referral to psychological counseling. We may refer you to one of our expert psychologists or psychiatrists for counseling. These professionals will help you cope with your pain and its effects on your life, and allow you to respond better to pain treatment.
• Nerve blocks. Nerve blocks keep your occipital nerve from sending pain signals to your brain. The nerve block will stop the pain in as little as 15 minutes and can last several weeks. When it wears off, you can return for another nerve block injection. Nerve blocks can also help diagnose the source of pain.
• Nerve stimulation. Electrical impulses sent through your occipital nerve may block pain signals to your brain. Your physician places a temporary wire through your skin and into your occipital nerve. Your physician then sends electrical impulses through the wire to see if it relieves pain. If stimulation works, your physician can implant a permanent generator under your skin.
• Radiofrequency lesioning. If you have severe chronic pain, you may choose to undergo radiofrequency lesioning, also called radiofrequency ablation. During this 20 to 30 minute procedure, your physician directs special radio waves at your occipital nerve through a small needle. The radio waves burn the nerve so it no longer sends pain signals.