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What Is Occipital Neuralgia?

By Lia Stannard ; Updated August 14, 2017

With neuralgia, patients have sharp pain that occurs on the affected nerve. Occipital neuralgia involves the occipital nerves, which are located by the neck's second and third vertebrae. Patients with occipital neuralgia can have problems with the left, right or both occipital nerves.


Johns Hopkins Medicine notes that occipital neuralgia can occur spontaneously without an apparent cause, or it can occur due to a pinched nerve root in the neck as a result of arthritis. Tight muscles that put pressure on the nerve can also cause occipital neuralgia, or it can come as a result of prior injury or surgery. The American Association of Neurological Surgeons adds that other medical conditions, such as cervical disc disease, gout, diabetes, blood vessel inflammation, an infection or a tumor may also cause occipital neuralgia.


Occipital lobe neuralgia is a type of chronic headache that starts in the upper neck and spreads to the ears. The pain is shock-like, piercing or throbbing. Patients' scalps can become tender, and they can be sensitive to light. Neck movements can trigger pain.


Doctors diagnose occipital neuralgia using a variety of techniques. The patient's medical history may reveal previous problems that could cause the nerve damage. The doctor will also give the patient a physical and neurological examination, checking for any problems with head movement. If the doctor suspects occipital neuralgia after the physical and neurological examinations, she will request brain scans, including computed tomography and magnetic resonance imaging scans, or CT and MRI scans.


The American Association of Neurological Surgeons explains that treatment options include surgery, medication, nerve blocks and massage. The goal with these treatments is to reduce inflammation of the nerve and eliminate pain. The two surgical options include microvascular decompression and occipital nerve stimulation. Microvascular decompression involves the doctor removing structures that put pressure on the affected nerve. With occipital nerve stimulation, the patient receives electrical impulses to the nerve through lead wires implanted under the skin. Medication options include muscle relaxants, anti-inflammatory medications and anticonvulsants, which include gabapentin and carbamazepine. With nerve blocks, the doctor temporary deadens the nerve by burning, cutting or injecting a toxin in the nerve.


The National Institute of Neurological Disorders and Stroke points out that occipital neuralgia does not threaten patients' lives. Once the nerve damage improves, patients' conditions should improve.

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