Occipital Neuralgia Head Pain

I suffer with a neurological condition alongside my fibromyalgia known as Occipital neuralgia which is is a neurological condition in which the occipital nerves – the nerves that run from the top of the spinal cord at the base of the neck up through the scalp – are inflamed or injured but I couldn’t exactly tell you which because it’s something that I have had for years, it gradually came on and so trying to pin point how or why is difficult but I think for the past 6 years or so it’s been very crippling for me when it does happen which is about 5 times a month. Occipital neuralgia can be confused with a migraine, or other types of headache, because the symptoms can be similar. The tension and pain of Occipital neuralgia can actually create head pain so although it isn’t always classified as a headache, it sure feels like a huge one, I mean pain is pain. Whether or not Occipital neuralgia is related to fibromyalgia or not is not entirely sure but I have spoken to several survivors of fibro who complain that this is a big issue for them and since our condition is neurological, it makes sense that other areas depending on our symptoms can be triggers. I actually think fibromyalgia itself triggers other areas of pain that may not always be on the standard list os symptoms which continually changes according to new research so leave me a comment and let me know if you’ve ever had the same thing. Here’s some additional information to keep you aware. -Haullie Free-Volker

Symptoms of 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

Causes of Occipital Neuralgia

Occipital neuralgia is the result of compression or irritation of the occipital nerves due to injury, entrapment of the nerves, or inflammation. Many times, no cause is found.

There are many medical conditions that are associated with occipital neuralgia, including:

  • Trauma to the back of the head
  • Neck tension and/or tight neck muscles
  • Osteoarthritis
  • Tumors in the neck
  • Cervical disc disease
  • Infection
  • Gout
  • Diabetes
  • Blood vessel inflammation

Diagnosing Occipital Neuralgia

If you think you may have occipital neuralgia, make an appointment with your doctor. Your doctor will ask questions about your medical history and any injuries you may have had, perform a physical exam, and may order certain tests, such as blood tests or an MRI scan. Your doctor may also give you an anesthetic nerve block to see if it relieves the pain. If it works, occipital neuralgia is likely the cause of the pain.

For treatment to work, it is very important that you receive an accurate diagnosis. For example, if you have occipital neuralgia and are prescribed migraine medication, you may not get relief.

Treatments for Occipital Neuralgia

Treatment depends on what is causing the inflammation or irritation of the occipital nerves. The first course of action is to relieve pain. There are a number of things you can try to get relief, including:

  • Apply heat to the neck.
  • Rest in a quiet room.
  • Massage tight and painful neck muscles.
  • Take over-the-counter anti-inflammatory drugs, like naproxen (such as Aleve) or ibuprofen (such as Motrin).

If these self-care measures don’t work, your doctor may prescribe the following medications to treat occipital neuralgia pain:

  • Prescription muscle relaxants
  • Anticonvulsant drugs, such as Tegretol (carbamazepine) and Neurontin (gabapentin)
  • Antidepressant medication
  • Short-term use of local nerve blocks and steroid injections

Surgery may be considered if pain does not respond to other treatments or comes back. Surgery may include:

Microvascular decompression. During this procedure, your doctor may be able to relieve pain by identifying and adjusting blood vessels that may be compressing the nerve.

Occipital nerve stimulation. In this procedure, a neurostimulator is used to deliver electrical impulses to the occipital nerves. These electrical impulses can help block pain messages to the brain.

Occipital neuralgia is not a life-threatening condition. Most people get significant pain relief by resting and taking medication. However, if you do not get relief and continue to experience neck and head discomfort, tell your doctor. There may be another reason for your pain that should be considered.





  1. I am fairly certain I have this… Never knew what it was called. I recently had facet injections on my neck which gave some relief. The injections (cortisone) wore off in abt 3-4 weeks. Now they want to do more up higher in my neck, then if these don’t permanently work, to burn the nerves in my neck to feel no pain. Has anyone had this done? Honestly, no one has called this occipital neuralgia, and I’ve had the mri’s. I’m on muscle relaxers, lyrica, anti-depressants, the whole lot!

  2. I had this and have been treating it with myofascial release and a form of chiropractic that does not crack bones, but rather works on muscles and traction. First time I have had relief in 20 years. Please try it –

  3. I was diagnosed with flares if occipital neuralgia that were relieved with an occipital nerve block. My “shocks” commonly occur near the top of my scalp underneath my ear at one point of the nerve. I have also been diagnosed with fibromyalgia. When I have severe tension and my neck muscles are sore I can feel an occipital flare coming on….so I do neck stretches which help.

  4. Thank you for writing about this. I’ve had problems for years and finally doc says its occipital neuralgia and fybromyalgia. They seem to work hand in hand with the pain and I’m having a hard time getting relief. Doc says he wants to try a nerve block. Hopefully will help.

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