About occipital neuralgia
The greater and lesser occipital nerves travel from the top of the neck through the muscles at the base of the skull and into the scalp. When they are compressed or irritated, they can send brief jolts of sharp pain from the base of the skull up over the head, sometimes toward the eye.
Between attacks, the scalp may feel tender or sensitive to light touch, such as brushing hair or resting on a pillow. Seek emergency care for a sudden, severe headache that feels like the worst of your life, headache with fever and stiff neck, or new weakness, confusion, or vision loss.
Common symptoms
- Sharp, shooting, or electric pain at the back of the head or upper neck
- Pain on one or both sides that travels up over the scalp
- Scalp tenderness or sensitivity to touch
- Pain behind the eye on the same side
- Aching between the jolts of pain
Common causes and risk factors
- Tight neck muscles that compress the nerves
- Whiplash or other neck injury
- Arthritis in the upper neck
- Prolonged forward head posture at a desk or screen
How we diagnose it
Dr. Chen examines the neck and presses along the path of the occipital nerves to see if this reproduces your pain, and checks for signs of other headache types. Ultrasound can show the nerves and surrounding muscles. A diagnostic nerve block that relieves the pain helps confirm the diagnosis.
How Propel treats occipital neuralgia
We start with neck and upper back strengthening, posture and workstation changes, and attention to sleep position and stress. Medications for nerve pain may be used alongside these steps.
Dr. Chen performs ultrasound-guided occipital nerve blocks, which let him see the nerve and place medication precisely. When blocks help but pain keeps returning, radiofrequency treatment of the occipital nerves may provide longer relief.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about occipital neuralgia
- Is occipital neuralgia the same as a migraine?
- No. Occipital neuralgia causes brief, sharp, electric jolts along a nerve path, while migraine usually causes throbbing pain that builds over time with nausea and light sensitivity. The two can overlap, and some people have both.
- Why use ultrasound for an occipital nerve block?
- Ultrasound lets our physician see the nerve and nearby blood vessels in real time. This helps place medication accurately and can reduce the amount needed.
- How long does an occipital nerve block last?
- Relief varies from person to person. Some people have relief for weeks or longer, and blocks can be repeated. When relief is short, other options such as radiofrequency treatment may be discussed.