Occipital Neuralgia: Symptoms, Causes, and Treatment

Occipital neuralgia is one of the causes of why people get headaches. It can be caused by an underlying medical condition like tumors, injury, or disease.

Man hand on forehead due to headache

Occipital neuralgia is one of the causes of why people get headaches. It happens in the occipital nerves, which are located in the second and the third vertebrae of your neck. The pain caused by occipital neuralgia starts on the base of the head and up to the eyes until it travels to the sides of the head. The pain goes back and forth starting from the nape and ending in the sides of the head. This condition is such a literal pain in the neck because it can find you anywhere at any time of the day. Usually, there is no telling that the headache will come; it will just come suddenly in a full-blown manner you would not expect. That is why people with occipital neuralgia should consider having alternative treatments to manage their symptoms because it might affect their lives in any case imaginable.


The occipital neuralgia can be caused by an underlying medical condition like tumors, injury, inflammation, disease, or internal hemorrhage. If the occipital neuralgia is caused by an underlying medical condition, it is categorized as a secondary form of headache syndrome. On the other hand, if it is categorized as primary, it means that occipital neuralgia has no underlying medical condition.

Occipital neuralgia can also be caused by nothing at all which happens commonly to people, but if it does, it usually is caused by unprecedented stress on the nape of your neck in general. Aside from neck tension, occipital neuralgia can be caused by the following but not limited to:

  1. Spine conditions
  2. Injury to the occipital nerves
  3. Cervical disc disease
  4. Tumors
  5. Inflammation in the area
  6. Infection


The symptoms of occipital neuralgia are similar to migraines. The pain in the head is quite extensive at times, and when and at times, it is mild.

The pain caused by occipital neuralgia starts at the base of the head, usually in the nape or in the neck, and then, it runs along the sides of your head. The pain from the occipital neuralgia is oftentimes felt in both sides of the head, sometimes, on one side of the head. Sometimes, people can feel the pain at the back of their eyes when the pain from occipital neuralgia radiates. Movements like neck movements might increase the pain in the head. So try to prevent moving your head vigorously when the occipital neuralgia pain episode starts.


In diagnosing this condition, the doctor or neurologist should be spot on his or her test. There are myriads of types of headaches out there, and most of them have similar symptoms and causes, so distinguishes them right away can be challenging.

The doctor takes out of the patient’s symptoms and how it will affect the everyday life of the patient. If, after the elaborate tests were done on the patient, then a neurological disorder has come out from the tests, the doctor will conduct other tests too. The following test is to follow up tests but is not limited to:

  1. MRI or Magnetic Resonance Imaging: MRI is a full-body scan that gives you 3D imaging of the structures of the area or part that you want to focus on. MRI uses powerful computer technology and magnets to show these 3D images.
  2. Computed Tomography Scan or CT Scan: CT scan is done when a doctor sees an abnormality in the area previously checked. It primarily uses x-ray technology to give out images of the aberration part.

The Treatment

The goal of treating it is always to try to soften the symptoms. There are over the counter painkillers in the market that could counter the pain that the occipital neuralgia headache might bring. There are non-medicinal treatments that you can use too to alleviate the pain like massage, sleeping, or resting.

Nerve block treatment can also be used, however, it is worth noting that the usage of steroids might induce troubling effects in the body, especially your kidneys.

Surgical Treatment

This treatment is a big leap because it involves the nerves and your brain. You have to weigh the risks of surgery, the, and your health condition. Meaning, you have to think through whether you would want to do it. Surgical intervention is usually done when the symptoms of occipital neuralgia headache are chronic, episodic and during its attacks, the pain is so severe that it would interrupt your daily activities. In addition to that, surgical intervention is also considered if your body does not respond to the other optional treatments.

Microvascular Decompression

The nerves affected by the occipital neuralgia headache is usually compressed and constricted. The pain sensitivity of occipital neuralgia headache is quite high. That is why occipital neuralgia headache can sometimes be really painful. The microvascular decompression aims to decompress the nerves and allow it to reduce its pain sensitivity. The microvascular decompression allows the nerves of the affected area to be pain-free and to be normal again, compared to its former constricted structure. The microvascular decompression uses the microsurgical method in treating the affected nerves. The nerves to be treated are usually the postganglionic nerve, nerve root, and the ganglion nerve.

Occipital Nerve Stimulation

The occipital nerve stimulation is used to stimulate the affected nerves. This method uses electrical impulses as a stimulator of the nerves. The occipital nerve stimulation is noninvasive, meaning, and it will not suffer the complications people who had brain surgery might have in the future. This procedure will blow minimal or no damage at all in the affected nerves of the occipital neuralgia headache.

Symptoms of Occipital Neuralgia

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