Occipital Neuralgia Symptoms

occipital neuralgia pain

Occipital Neuralgia

Occipital Neuralgia is a term that describes a cycle of pain/spasm/pain that originates from the suboccipital area which is known as the base of the skull that often extends to the front, back, and side of the head, as well as behind the eyes.

Most of the feeling in the back and top of the head is transmitted to the brain by the two greater occipital nerves. There is 1 nerve on each side of your head. The two occipital nerves emerge from between small bones in the spine in the upper neck and make their way through muscles at the back of the head, into the scalp. They can potentially reach nearly as far forward as the forehead, but do not cover the face or the area near the ears mainly because other nerves supply these tender regions.

Occipital Neuralgia Pain

The pain of occipital neuralgia begins in the neck and then spreads up the spine to the back of the head. The scalp may also be very tender to the touch and the eyes become especially sensitive to light. The pain location 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.

Occipital Neuralgia Causes

The pain is caused by injury or irritatiion 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 as it leaves the spine due to osteoarthritis, 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.

Occipital Neuralgia Diagnosis

Occipital neuralgia can be diagnosed and temporarily treated by an occipital nerve block. Other ways to treat occipital neuralgai are: peripheral nerve stimulation, steroids, rhizotomy, phenol injections, antidepressants, and Occipital Cryoneurolysis.
For patients who do well with this temporary “deadening” of the nerve, a more permanent procedure may be a good option to help manage pain. These treatments include:

  • cutting the nerve surgically
  • “burning” the nerve with a radio-wave probe
  • eliminating the nerve with a small dose of an injected toxin.


Occipital neuralgia is not a life-threatening condition. Many individuals will improve with therapy involving heat, rest, anti-inflammatory medications, and muscle relaxants. Recovery is usually complete after the bout of pain has ended and the nerve damage repaired or lessened.

18 Responses to Occipital Neuralgia Symptoms

  1. rich haddad says:

    i have had occipital neuralgia for 2 years,and it has gotten better but I have re-agrivated it twice.The focal point is top left corner of my head and then covers the entire occipital region of me head.Nerve blocks every 19 days,help and I also take lyrica and use a lidocaine gel. What else can I do?

  2. judith says:

    I have recently been diagnosed. I had a car accident 19 months ago and re-injured my neck on a rollercoaster ride last December. Glad to have the diagnosis but need more help with the pain. Heat and chiropractor visits helped last time. Time, heat and rest helped 1st time so we’ll see where we end up this time. Not interested in surgery or burning anything. Not desperate enough.

    • neuralgia says:


      I wish you the best of luck and hope everything goes well for you. I will keep you in my prayers. Have a great day and thanks for visiting my site.

  3. Samantha says:

    I was diagnosed with occipital neuralgia about 2006. I have yet to find a solution for the problem which keeps coming back as soon as I do upper body movements. I have a bunch of medical issues on top of that. We have tried the freezing shots over and over and over again..It almost seems now that the freezing is no longer working. I have been on Lyrica for probably 4yrs now. It almost feels as though that is no longer working. I am now at the stage where I am investigating the option of surgery of some sort. I beg the DR’s to knock me out or cut my head off. This is pain I can no longer handle. I have anxiety attacks knowing that it will get worse. I’ve tried different types of pain meds and they don’t seem to work much. they just simmer it down a little. I am hoping they will come up with some sort of procedure here in Canada but I am doubtful. I see the neurolagist but there still isn’t anything around here. It really sucks not being able to do things knowing it will trigger these nerves..I’ve even got a traction unit and it no longer works. If there is a cure I sure need it now…

    • Dawn Jones says:

      Samantha. My daughter has just been diagnosed with ON. She has had debilitating pain for 8 yrs. I found a surgeon in DC that does decompression surgery. She had the surgery April 18 and is finally getting relief. If you’re interested I will give you the information. Many patients have experienced significant relief after the surgery.
      I live in Memphis TN and have taken her to 140 Drs with no help. Were hoping and praying this will give her life back.

      • michael blanton says:

        hi i had a bad head injury in 2003 i have been to doctors and more doctors it seems like it never ends. i have (on) and i get spasms in my neck witch go up to the base of my skull and over my left side of my head to my right eye.. the headache pain in untollerable at times..i have tried seems like everything but sergery..i would really like to know more about what u can tell me bout the procedure your daughter had to help hers…we will keep her in our prayers hopefully things get better for her. i have a wife and 3 kids of my own and life has been hard the past 8 years for me because of the pain…sincerely michael blanton

      • william smith says:

        I’m glad to hear your daughter has found someone to assit – can you refer to me the same physican

    • Tanya says:

      Hi Samantha

      Have you thought of undergoing occipital neurectomy? I have been diagnosed and will definately go for this operation soon, as I would rather try this in the hope it works, than to live on pain killers for as long as it takes to heal, if ever? Which ever you decide, I hope your condition improves. Regards, Tanya, South Africa.

    • christine says:

      Today I was told I have Occipital Neuralgia, I hope I can have better luck than you are having, I thought I would take the pills Gabapentin and it would go away! Christine

    • Tiffani says:

      Hi. I just had a phenol burn for my neuralgia. It hurt like hell. I’m not sure it did any good. The L side of my head is still so sore from the injections. I think I may have to live in pain forever. Sometimes I wish I could cut my head off too! Not that I wish pain on anyone, but it is amazing to hear people describing their troubles with neuralgia and it’s like wow, there are other people going through the same thing. I hope they come up with some miracle….

      • neuralgia says:

        I wish you best! I hope they come up with a cure too. I am sorry about the phenol burn. Good luck with everything and have a great day!

  4. Iris says:

    I have been diagnosed with ON. Mine started with zapping..like electric wires. this has been going on since 2005. Any med. they have give me has the reverse affect making it worse. I have dizziness and lose my balance..Am now thinking of getting the freezing done, though am scared, but getting to the point now where I am willing to try anything.

  5. Iris says:

    Does anyone else associate dizziness and loss of balance with this..Thanks

  6. I was hit by tractor trailor about a year ago and this pass March I was diagnosed with occipital nerve damage I can no longer lay on my leftside to try to sleep or rest my head on anything and have a constant pain, pressure all the time and worst when bad weather comes .Does this ever get better? I loose balance somtimes and now my left foot is numb and tingley.I have always been a very healthy person until this accident but I guess i should be thankfull I am alive. I am not desperate enough to get surgery because i am scared to death that it might get worst . I bought some of those special pillows that seem to help a bit but my days of sleeping well are gone!!!It has been 10 months since my accident please tell me it will get better!!!! Thank you Marlene Going to see Doctor again and maybe try a chyropractor?????

  7. Dee says:

    Have them check your carotid artery. I’ve been diagnosed with occipital neuralgia and have been in pain for the last 10 months. I have extreme burning pain that originates from my right sub-occipital triangle and travels up the back of my head, around to my jaw, and down my right shoulder. It sometimes hurts at the center of the back of my head. My muscles are so contracted and inflamed in the sub-occipital triangle that it’s caused my jaw to go out of alignments which they say has resulted in TMJ. It sometimes hurts to talk, chew, yawn and smile. I have difficulty sleeping and I’m becoming increasingly depressed. This is extremely frustrating because I can no longer enjoy yoga and many of the other activities that I love. At the doctor the other day I noticed something in the right side of my neck was larger than in the left. The neurologist told me that the condition is aggravating my carotid artery. She said to be sure not to rub it because it is what supplies the blood to the brain and it will make you pass out. You may want them to check yours as well. To all of the other folks suffering from this condition. I wish you good health, comfort and freedom from suffering.

  8. Barb Hoffarth says:

    Hi I had ON since 2006, I have getting occipital nerve blocks but sure they are still working. I have noticed after each shot my left eye is getting more senitive to light. Has anyone else had this problem? My doctors in ND, haven’t mentioned surgery yet but I have a feeling it will happen. I’m hoping they find a better alternative to Lyrica 200mg 3 times a day and tramadol. I have been on Lyrica since 2006. I also have fibromylagia which don’t help. I have learned that these go hand and hand.Has anyone else been diagnosed with both?

  9. elle jinx says:

    8 months ago, a stupid rhumathologist moved my neck too strongly and damaged my occipital nerve. The truth about this horrible thing is that no one recovers. I am suffering since 8 months. I’ve had injections 4 times: one in the base of the nerve, one into the muscle, and two under radioscopy (first in the nerve, second between c1 & c2). All I can say is this is a nightmare that will never end. Before the injections, the pain was only on the nerve. But since I had there horrible injections, my scalp is so sensitive I can barely touch it, or comb my hair, or do a ponytail. It’s burning like hell! I am taking Rivotril drops since 5 montgs. I tried Lyrica and Tegretol but they hurt my stomach. I even had morphine. I had different massage techniques on my neck. I even tried accupuncture. I do not want the operation to get the nerve removed because I am too scared. The only two things I haven’t tried are botox injections andmesotherapy. If anyone found a way out of this hell, please help me. Thank You, Elle

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