Occipital neuralgia is a headache disorder that affects your occipital nerves. Your occipital nerves are the nerves that run through your scalp. You may experience sharp, stinging or burning sensations on your scalp or behind your eye. Most people experience pain relief with the right treatment.
Occipital neuralgia is a type of headache disorder. The condition occurs when your occipital nerves become inflamed. Your occipital nerves carry messages from your brain through your scalp. Nerve inflammation is irritation or swelling around your nerve.
Occipital neuralgia can affect anyone. You may be more likely to suffer from occipital neuralgia if you have:
Occipital neuralgia pain may last for only a few seconds or may affect you for hours. For most people, symptoms decrease with noninvasive treatments. Typically, the pain goes away when the nerve damage heals or decreases.
Occipital neuralgia symptoms affect your head and neck. If you have occipital neuralgia, your symptoms may occur only briefly. Sometimes, symptoms are chronic (long-lasting).
Occipital headache pain may start behind one eye or at the back of your head. The pain may feel like:
Diagnosing occipital neuralgia can be tricky. The condition causes many of the same symptoms as migraines and other headache disorders. No one conclusive test will confirm occipital neuralgia.
Your neurologist (brain and spine specialist) may order tests such as:
Occipital neuralgia treatment focuses on decreasing pain when you have symptoms. A range of nonsurgical or surgical treatments can help.
Nonsurgical treatment may include:
Your healthcare provider may also prescribe medications such as:
If your symptoms don’t improve after trying nonsurgical treatments, your healthcare provider may recommend surgery. Surgical treatment for occipital neuralgia includes:
If your pain is mild to moderate, you may feel better after a week or two of using treatments such as medications, therapy and nerve blocks. If your pain is more intense, it may take four to six weeks before you notice an improvement.
If you have a spinal cord stimulator, for example, you may need to return to your healthcare provider to adjust the stimulation settings every few weeks until you feel pain relief.
If you have occipital neuralgia, you may not be able to prevent pain altogether. Massaging your neck and stretching can help release tight neck muscles. Tight neck muscles can lead to symptom flares.
For example, try practicing chin tucks a few times a week. (But if the exercise increases your pain, stop immediately and see your healthcare provider.) To perform a chin tuck:
Occipital neuralgia isn’t life-threatening. With the proper treatment, pain improves for most people. Once your nerves heal, the pain usually goes away. You may need to continue stretching or taking medication to keep the pain from returning.
Depending on the type of treatment you use, occipital neuralgia pain may come back. For example, if your healthcare provider gives you a steroid injection, the effects of the shot may wear off after three to six months. You may need to visit your healthcare provider from time to time to manage occipital neuralgia symptoms.
Most of the time, occipital neuralgia pain isn’t an emergency. You should seek immediate treatment if head or neck pain also causes:
A note from Cleveland Clinic
Occipital neuralgia can cause sudden, sharp and intense pain. Usually, this pain runs along your scalp or feels like a throbbing sensation behind your eye. Occipital neuralgia shares many of the same symptoms as other headache disorders. Treatment options like hot and cold therapy, stretching and massage relieve the pain for many people. If your symptoms don’t go away with noninvasive treatment, you may be a candidate for a spinal cord stimulator or occipital nerve stimulator. Treatment relieves the symptoms for most people.
Last reviewed by a Cleveland Clinic medical professional on 05/21/2022.
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