Occipital Neuralgia


Occipital neuralgia is a persistent pain condition that causes sharp, stabbing pains near the base of the skull that radiate throughout the head.


The most common symptoms of occipital neuralgia include:

  • Bilateral headache
  • Pain behind the eyes
  • Pain at the skull base
  • Dizziness
  • Hypersensitivity on the scalp
  • Neck stiffness
  • Blurred vision or other vision disorders


Causes of Occipital Neuralgia

Occipital neuralgia is attributed to irritation or damage to the greater or lesser occipital nerve. Nerve damage can be caused by injury, stress, infection, or repetitive neck movements, including frequent neck bending.

Categories of Occipital Neuralgia

According to relevant research, the causes of occipital neuralgia are divided into four categories:

  • Vascular factors:
    They include nerve root irritation
  • Neurogenic factors:
    They include pain originating from nerve tissue
  • Muscular factors:
    They include pain that originates in the muscles
  • Osteogenic factors:
    They include pain originating from the bones

Treatment Options

Treatment options for occipital neuralgia vary. Depending on symptom severity and intensity, pain management is achieved by applying the following interventions, either individually or combined.

Non-invasive treatments for mild symptoms

If the symptoms of occipital neuralgia are mild, interventions including relaxation exercises, yoga, meditation, and the application of heat or cold to the neck are recommended.
There are also adjunct treatments, such as chiropractic, physiotherapy, acupuncture, and massage, that can help manage pain when a patient does not respond to the above treatments.

Drug Therapies
Nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and muscle relaxants are some examples of common medications used to treat occipital neuralgia.

Invasive Treatments

Occipital nerve block
Occipital nerve block is recommended for cases where occipital neuralgia symptoms are moderate to severe. The procedure involves injecting a topical anesthetic and steroid into the nerve region. By using this method, it is possible to significantly lessen pain by blocking the pain signals coming from the affected area.
Botulinum toxin injections
Injections of botulinum toxin (Botox) into the nerve tissue aid in reducing pain by obstructing excessive nerve impulses.
Radiofrequency therapy
Transcutaneous radiofrequency neurolysis is a minimally invasive method that involves the subcutaneous insertion of an electrode through a special needle, which electrically stimulates the affected nerve and blocks the transmission of pain signals to the brain. It is recommended for patients who do not respond to non-invasive treatments for occipital neuralgia.
In rare cases, when a patient does not respond to any therapeutic intervention, surgery is advised. Depending on the case, either microvascular decompression or occipital nerve stimulation can be performed.