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Occipital Neuralgia: Symptoms, Causes, and Treatment

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

This disease manifests itself in the form of a headache. The symptoms of occipital neuralgia may consist of intense shooting pain in the back of the head and neck. Alternatively, it can be tenderness or hypersensitivity to touch in these areas. It also can be discomfort that may be intensified by head or neck movements. Pain can be debilitating, hindering one’s ability to carry out daily activities. Pain can be debilitating, hindering one’s ability to carry out daily activities.

Such a disorder can happen because of irritation or injury to the occipital nerves. These nerves run from the top of the spinal cord to the scalp. Common causes include physical trauma, nerve compression, and inflammation.

This condition is diagnosed through a patient’s complaints and a physical examination.  A cure can include some medication, physical therapy, or nerve blocks. In severe cases, it can be surgery. Surgery can help to alleviate pressure on the affected nerves.

In this article, we’ll talk about occipital neuralgia, its symptoms, and its causes. Also, we’ll talk to you about treatment for it.

What is Occipital Neuralgia?

Actually, it is a type of chronic pain. It affects the occipital nerves. Certain movements or activities, such as turning the head or lying down, can trigger this pain.

  • Common complaints of patients include pain in the back of the head and upper neck. Also, it can be because of tenderness or sensitivity to touch in the affected area. Some people may face numbness or tingling in the scalp. They can also feel fullness or pressure in the head.
  • Diagnosis of this disease begins with complaints of patients and physical examination. You can also have additional tests. It can be such as imaging studies or nerve conduction studies. 
  • A cure will depend on the underlying cause of this condition. And also it depends on the severity and frequency of symptoms. Non-surgical ways of cure may include medication to control pain and inflammation, physical therapy, and nerve blocks. Surgery may sometimes be necessary to relieve compression on the affected nerves.

It’s vital to consult with a doctor if you have persistent head or neck pain. He will be able to find the reason for your problem and find the right cure.

Occipital Neuralgia Symptoms

The manifestation of this disease can vary among individuals. But common complaints of patients include:

  • Sharp or aching pain in the back of the head and upper neck. The pain is frequently described as piercing, shooting, or stabbing and can be so severe as to cause headaches. 
  • It often intensifies with specific movements or activities such as turning the head, lying down, or applying pressure to the affected region.
  • Tenderness or sensitivity to touch in the affected area. Patients with occipital neuralgia may have pain during washing or touching a head.
  • Numbness or tingling in the scalp. Some people feel numbness or tingling in the scalp. Because of it, people can feel pain.
  • A feeling of fullness or pressure in the head. Some people with this disease may feel a sense of fullness or pressure in the head. It can cause pain.

Symptoms of this disease can be debilitating. It can significantly impact a person’s quality of life. Patients with this condition can have bad sleep and low productivity in their work. It can also make it difficult to focus or concentrate. The symptoms may come and go, or they may be constant and severe.

What Causes Occipital Neuralgia?

causes of occipital neuralgia

The exact reason can vary. But some common triggers include:

  • Trauma or injury to the head or neck: It can cause damage to the occipital nerves, leading to irritation and pain.
  • Cervical spine disorders: Conditions such as degenerative disc disease and herniated discs. Osteoarthritis can put pressure on the occipital nerves, leading to pain.
  • Tension headaches: Tension headaches are the most common type of headache. They can cause pain in the occipital region.
  • Inflammation: Inflammation can occur due to a variety of causes. It can be an infection or a disease like rheumatoid arthritis.
  • Blood vessel disorders: Conditions such as high blood pressure or atherosclerosis can cause blood vessels to constrict, leading to pain in the occipital region.
  • Tumors: In rare cases, tumors may compress the occipital nerves, leading to pain.
  • Genetics: Some people may have a genetic predisposition to developing this disorder.
  • Other medical conditions: Certain conditions can increase the risk of developing this neurological disease. For example, it can be diabetes. 

Note that this disorder can be mistaken for other types of headaches. For example, it can be mistaken for migraines. See a doctor for an accurate diagnosis and appropriate cure.

Occipital Neuralgia Diagnosis

The diagnosis of this disease begins with a physical examination and a review of history. The doctor will ask about the patient’s complaints. It will include questions such as when the pain began, how often it occurs, and what makes it worse or better. 

  • The provider will also examine the patient’s head, neck, and shoulders. It will help to look for signs of tenderness, swelling, or other abnormalities.
  • Doctors can use imaging studies such as X-rays, CT scans, or MRIs. These studies can help to identify any underlying conditions. These conditions may be causing the patient’s symptoms, such as a herniated disc or a tumor.

There are a lot of underlying conditions which can cause this neurological disease. A thorough examination and investigation will help to correct diagnosis and treatment.

Non-surgical Treatments

While surgery is an option in some cases, there is also a non-surgical treatment that can effectively manage occipital neuralgia.

  • One of the most common treatments is medication. Over-the-counter pain relievers such as ibuprofen and acetaminophen can help to alleviate pain. At the same time, you can use prescription medications to target specific symptoms. It can be tricyclic antidepressants and anticonvulsants. You may also use corticosteroid injections to reduce pain in the affected area.
  • Physical therapy is another effective non-surgical treatment for occipital neuralgia. Physical therapy can help to strengthen the muscles in the neck and shoulders. It can, in turn, reduce pressure on the occipital nerves. You can use stretching and massage to alleviate pain and improve your range of motion.
  • A nerve block is another non-surgical treatment. You can use them to alleviate the pain. A nerve block involves injecting a local anesthetic into the affected area. It will help to numb the nerves temporarily. It can provide temporary relief of pain and help diagnose the condition.

Other non-surgical treatments for occipital neuralgia include:

  • Acupuncture: This traditional Chinese medicine technique involves using thin needles. Doctors put them into specific points on the body. It helps to stimulate the nervous system and promote healing.
  • Chiropractic care: Chiropractors use manual adjustments to the spine. It will help alleviate pain and improve the range of motion.
  • Transcutaneous electrical nerve stimulation (TENS): This non-invasive treatment uses electrical impulses. It helps to stimulate the nerves and reduce pain.

The most effective treatment will depend on the underlying cause of the condition. You should consult with a healthcare provider. It will help to determine the best course of treatment.

Occipital Neuralgia Surgery

There are some variants of occipital neuralgia surgery:

  • One surgical option is nerve decompression surgery. It involves releasing pressure on the occipital nerves by removing any structures. It may be compressing them, such as tumors or bony growths. 
  • Another option is nerve stimulation. Doctors can implant electrodes near the occipital nerves to deliver electrical impulses. It helps to reduce pain.
  • In some cases, doctors can use a combination of both nerve decompression. Also, it can be nerve stimulation. Be thoroughly evaluated by a neurosurgeon to determine the cause of occipital neuralgia and to determine if surgery is the best course of treatment. 

Recovery from surgery can vary. It can depend on the type of surgery and the individual patient’s health. In general, patients can expect to experience some pain and discomfort. They can feel it for several weeks after surgery and may need to limit their activity during this time.

Note that surgery is not always successful. It may not completely eliminate pain. In addition, there is always a risk of complications with surgery. It can be infection, bleeding, and nerve damage. Discuss the benefits and risks of surgery with a neurosurgeon before a decision.

Overall, doctors consider occipital neuralgia surgery as a last resort. To start, there can be other treatment options. It carries risks and may not be effective. So, patients should discuss their options with their doctors. Only after it should patients make an informed decision.

When Should You Visit a Doctor?

If you have chronic pain in the back of your head and neck, you should visit a doctor. He will help you to figure out the reason for the disorder and find the right cure. Here are some important signs of the development of this disorder:

  • One of the first signs of occipital neuralgia is pain that you feel in the back of the head and neck. Often patients can describe it as a sharp or shooting pain. Certain activities or movements can trigger this pain. It may be constant. 
  • Indeed, patients can face tenderness or sensitivity in the affected area. It can cause headaches and muscle spasms.

If you have some of these problems, it is important to visit a doctor as soon as possible. A doctor can perform a physical examination. Also, he may order imaging tests, such as an MRI or CT scan. It will help to determine the cause of the pain and to rule out other potential causes.

A neurosurgeon or neurologist specializes in diagnosing. They prescribe treatment for occipital neuralgia. They will do a physical examination and a review of your medical history. It will help to determine your pain’s cause and recommend an cure.

In addition to a visit to the doctor, it is also vital to keep a pain diary. It should include some vital information. So, it should be questioned when the pain occurs and how severe it is. Also, write what activities or movements can trigger it in your opinion. This information can help a doctor make the right diagnosis. Also, it helps to find an effective way of treatment.

In some cases, conservative ways of treatment may be effective. So, you can try physical therapy, nerve blocks, or some medications for treating occipital neuralgia. However, if these methods of treatment do not give a good result, a doctor can suggest surgery. But it is considered a last resort.

Bottom Line 

So, in this article, we have discussed occipital neuralgia, its causes, diagnosis, and treatment. This condition can significantly impact the patient’s quality of life. If you have chronic pain in the back of your neck or head, it’s vital to visit a doctor. You need to do it as soon as possible to determine the cause and to recommend the right cure.  

Lone Star Neurology clinic is a medical facility. We specialize in treating neurological conditions. We provide a wide range of services for patients. It includes diagnostics, treatment, and management of conditions. If you have some signs of neurological disease, our best specialists will make a full diagnosis testing and give you the best treatment! 


  • Is there a cure for occipital neuralgia?

There is no specific cure for occipital neuralgia. But treatment options such as physical therapy, medication, nerve blocks, and surgery may provide relief from symptoms.

  • Is occipital neuralgia dangerous?

Occipital neuralgia is not typically considered dangerous. But it can cause chronic pain and disability if left untreated. It’s important to seek medical attention if you experience symptoms.

  • How long can occipital neuralgia symptoms last?

Symptoms of occipital neuralgia can last for varying lengths of time. It can be from a few days to weeks to months or even years if left untreated.

  • What is the most common cause of occipital neuralgia?

Occipital neuralgia is often caused by injury or irritation of the occipital nerves. But can also be caused by tension headaches or cervical spine disorders.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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