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What is occipital neuralgia?

Steven A. Meyers, MD
Diagnostic Radiology
Occipital neuralgia is a headache disorder due to irritation of one of the occipital nerves in the back of the head. The pain typically is located in the upper neck and back of the head. It can radiate up the scalp toward the eye or ear. The pain is frequently described as sharp and stabbing or electrical in nature. There may be chronic dull upper neck pain or stiffness of the neck muscles. The pain tends to be one sided but can be bilateral.

Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. Typically, the pain begins in the neck and then spreads upward. Some individuals also experience pain in the scalp, forehead, and behind the eyes. Their scalp may also be tender to the touch and their eyes especially sensitive to light. The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head. The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head; pinching of the nerves by overly tight neck muscles; compression of the nerve, due to osteoarthritis, as it leaves the spine; or tumors or other types of lesions in the neck. Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia. In many cases, however, no cause can be found. A positive response (relief from pain) after an anesthetic nerve block confirms the diagnosis.

This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

Occipital neuralgia is a condition that causes severe pain in the back of your head and scalp. It often starts at the top of your neck and moves into the area behind your ears, eyes, and in some cases, forehead. The condition occurs when one or more of your occipital nerves gets damaged or becomes aggravated. The cause of this aggravation can be as simple as tight muscles, or as serious as pressure being put on the nerve by a tumor. Most of the time, the cause of occipital neuralgia cannot be determined, but for many people, a massage and some down time will help fix the issue.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.