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Occipital Neuralgia

Occipital Neuralgia Overview

Occipital neuralgia is a form of headache that is characterized by pain in the areas supplied by the occipital nerves, such as the upper neck, the back of the head, and behind the ears. The pain that is experienced in occipital neuralgia tends to be sharp and piercing in nature, lasting seconds to minutes at a time. The occipital nerves run from the upper cervical spine up to the scalp on the back of the head. Patients with occipital neuralgia can experience pain in front of the head via connections between occipital and trigeminal nerves.

Occipital Neuralgia Symptoms

Pain associated with occipital neuralgia is usually described as sharp, shooting, or stabbing pain beginning in the upper neck around the base of the skull and spreading up toward the scalp at the back of the head. Pain usually lasts a few seconds to a few minutes and is severe in intensity. Your scalp may also be tender or sensitive to the touch.

Occipital Neuralgia Treatments

The following may be used to treat occipital neuralgia:

  • Massages
  • Physical therapy
  • Nerve blocks
  • Steroid injections
  • Anti-inflammatory medications
  • Neuropathic pain medications
  • Antidepressants
  • Muscle relaxers
  • Surgery (rarely needed)

Additional Information

How common is occipital neuralgia?

Occipital neuralgia is relatively rare, affecting an estimated 3.2 per 100,000 people per year.

Who gets occipital neuralgia?

Occipital neuralgia can affect anyone who experiences damage or disease of the occipital nerve. There are several theories as to how the pain from occipital neuralgia develops, many of which have been refuted over the years.

How is occipital neuralgia diagnosed?

Your doctor may use the following to confirm a diagnosis of occipital neuralgia:

  • Medical history
  • Physical examination
  • Injection of local anesthetic along the occipital nerves (occipital nerve block) to see if the pain stops
  • Imaging to rule out other conditions

Additional Resources

The Neuralgias: Diagnosis and Management—Current Neurology and Neuroscience Reports
National Institute of Neurological Disorders and Stroke
American Migraine Foundation
International Headache Society

Medically Reviewed by Kerry Knievel, DO, FAHS on September 4, 2022