Occipital neuralgia is characterized by pain at the base of the head which spreads to the scalp towards the forehead resulting in a headache. This condition is due to irritation of nerves called occipital nerves that run along the entire scalp to the back of the head. Some of the most common causes of occipital neuralgia headaches include:

• Facet joint arthritis

  • Nerves that supply the first couple of facet joints in the neck join together to become the occipital nerves​

• Neck muscle spasms or muscle tightness

  • Occipital nerves can be compressed by certain muscles in the neck​

• Trauma

  • Car accidents​

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What type of pain can you experience with occipital neuralgia headaches?

Occipital neuralgia pain is mostly localized to the scalp region and can be associated with:​

• Throbbing pain 

• Burning pain

• Pressure behind the eyes

• Pain more commonly on one side of the head but can sometimes be on both

• Nausea

• Feeling unbalanced or lightheaded

• Tenderness when pressing on the scalp

• Pain that begins at the base of the head

• Pain with turning the head side to side

• Muscle spasms at the base of the head

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How can our St. Louis pain doctors help diagnose your occipital neuralgia headache?

At St. Louis Spine and Joint Pain Specialists, we have extensive experience diagnosing and treating headaches, especially occipital neuralgia. It is important to get the right diagnosis by highly knowledgeable pain doctors as the treatment for this type of headache is different than other types of headaches such as migraines.  

• Thorough history and physical exam. A good physical exam can locate muscles responsible for pinching or irritating the nerves. Muscles are the most common cause of occipital neuralgia.

• Xray

  • Evaluates for arthritis that could be causing the headaches​

• MRI

  • Only used to rule out other causes of headaches if symptoms do not entirely fit occipital neuralgia​

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What are your treatment options?

Occipital neuralgia can easily be treated with non-surgical procedures. Steroid injections are extremely beneficial for resolving or significantly reducing the frequency of headaches. Treatments includes:  

• Occipital nerve blocks

  • Blocks the irritated nerve resulting in decreased headaches

• Trigger point injections

  • Help with muscle spasms or muscle pain​

• Facet joint injections​

  • Used to treat facet joint pain​

• Non-steroidal anti-inflammatory medications (NSAIDS)

• Cold packs/heating pads

• Massage therapy

• Muscle relaxants

• Acetaminophen (Tylenol)

• Anticonvulsants

• Acupuncture 

• TENS​

  • Also blocks pain signals from affected areas​

• Physical therapy

  • Ultrasound, myofascial release

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What can you do to avoid or decrease occipital neuralgia headaches?

• Stretching the neck muscles

• Cervical pillow

  • Helps decrease tension on the neck muscles that could be causing headaches​

• Exercise​

  • ​The stronger your muscles are, the less prone they are to injury​ or spasms

• Adequate sleep

  • Studies show that lack of sleep causes increased muscle pain and potentially headaches

• Reduce stress

  • Yoga, meditation, relaxation techniques

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For more information or to discuss an appropriate treatment plan for your occipital neuralgia headaches with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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