For most patients, the pain from occipital neuralgia is severe, chronic, and can feel either throbbing or shocking.
Occipital neuralgia is a particular type of headache that is caused by the greater and lesser occipital nerves. Since these nerves stem from the first few vertebrae of the spine, the pain tends to radiate from the patient’s neck and skull base up to the rest of the scalp.
Patients may also experience pain behind their eyes which is accompanied by sensitivity to light.
How Is It Diagnosed?
Occipital neuralgia can often be confused with migraines or other neurological conditions, but it is critical that the correct diagnosis is reached because the treatment will be different. Fortunately, since this disorder is caused by injury to the occipital nerves specifically, a diagnosis can be reached by applying a nerve block directly to the occipital nerves. If this nerve block relieves the symptoms, then it is very likely that the patient is suffering from occipital neuralgia. The physician will probably run a number of other tests, such as a neurological assessment, MRI, and a physical exam. These additional examinations will allow them to eliminate the possibility of other conditions.
The nerve damage that causes the symptoms of occipital neuralgia can be the result of a number of diseases, including osteoarthritis, cervical disk disease, diabetes, direct nerve injury, or compression of the vertebrae.
What Are The Treatment Options?
Many patients are able to achieve pain relief through non-invasive measures. Once the diagnosis has been confirmed, the physician can recommend a treatment plan that is likely to include NSAIDs and massages. If the patient doesn’t notice any improvement with these measures, they may be referred to a physical therapist. Additionally, the physician may prescribe stronger medications such as muscle relaxers and tricyclic antidepressants. If these options still don’t provide relief, the physician may utilize a nerve block to relieve symptoms for the patient. In some cases, patients are unable to find relief through these methods and may be recommended for surgery. One of the surgical options is microvascular decompression, which involves exposing damaged nerves, identifying the blood vessel causing nerve damage and moving that blood vessel.
Occipital nerve stimulation may be another surgical option. This procedure involves placing electrical leads just under the skin above the occipital nerves. Then, electrical pulses will be sent through the leads to the nerves which will block the pain signals from being sent to the brain.
What Is The Long-Term Prognosis?
Unfortunately, there is not a known cure for occipital neuralgia. However, there are many treatment options available that make it possible for most patients to find relief. Additionally, this condition is not considered to be progressive or life-threatening. It is important that patients continue to communicate with their medical care providers as there are many conditions that frequently co-occur with occipital neuralgia. The medical team can make sure that the symptoms of occipital neuralgia aren’t masking the symptoms of a more severe condition.