Occipital Neuralgia

Occipital neuralgia can cause very intense pain that feels like a sharp, jabbing, electric shock in the back of the head and neck. Other symptoms of occipital neuralgia may include: Aching, burning, and throbbing pain that typically starts at the base of the head and radiates to the scalp, Pain on one or both sides of the head, Pain behind the eye, Sensitivity to light, Tender scalp, Pain when moving the neck.

Occipital Neuralgia:

Occipital neuralgia is a term used to describe a cycle of pain-spasm-pain originating from the suboccipital area (base) of the skull that often radiates to the back, front, and side of the head, as well as behind the eyes.

The occipital nerves are two pairs of nerves that originate in the area of the second and third vertebrae of the neck. Often the nerves follow a curving course that passes through various muscles in the upper back, neck and head. These nerves supply areas of the skin along the base of the skull and partially behind the ear. While the occipital nerves do not directly connect with structures within the skull itself, they do interconnect with other nerves outside of the skull and form a continuous neural network that can affect any given area through which any of the main nerves or their branch fibers pass.


Occipital neuralgia occurs more often in women than men. It can have many causes such as trauma (a direct blow or “whiplash”); spinal column compression; nerve lesions; localized infections or inflammation; gout; diabetes; blood vessel inflammation; and local tumors.

Commonly, the nerves are inflamed and sensitive because they are trapped within the muscles through which they pass. Muscle spasm and pain are often associated with nerve entrapment, which causes localized pain, spasm and muscle cramping.

Symptoms include the following:

Headaches that are localized or following a “ram’s horn” pattern on the side of the head, often starting in the upper neck or base of the skull. It can be one-sided or on both sides.

Scalp that is tender to the touch, often hypersensitive. Even brushing your hair can be a painful experience.

Pain or pressure behind the eyes. Eyes are very sensitive to light especially when the headache is present.


Occipital neuralgia’s can be treated in several ways. Some less invasive treatments are as follows: acupuncture, chiropractic manipulation,  physical therapy, rest, heat, anti- inflammatory medication, antidepressant medication, anti- convulsant medication, opioid and nonopioid analgesia, and migraine prophylaxis medication. Alternatives to these may include local nerve block, peripheral nerve stimulation,  C2 radiofrequency rhizotomy.