Occipital Neuralgia Symptoms: Neck Pain
Pain in the neck can be more than just a hassle. Neck pain can come from disorders and diseases of any structure in the neck. There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs and nearby pass the nerves of the neck. Within the neck, structures include the:
- neck muscles,
- arteries, veins,
- lymph glands,
- thyroid gland,
- parathyroid glands,
- esophagus, larynx, and
Disease of any of these structures can lead to neck pain.
What is occipital neuralgia?
Occipital neuralgia is a form of headache that causes pain along the upper neck and back of the head. The pain is in the distribution of the nerves known as occipital nerves (sensory nerves that run from the upper part of the neck to the back of the head). The pain can be throbbing, aching, burning, or can feel sharp and stabbing. Sometimes, this condition is referred to as occipital neuritis, suggesting there are some associated inflammatory changes that have affected the occipital nerves.
What causes occipital neuralgia?
The cause of occipital neuralgia is poorly understood. It is thought to occur when the occipital nerves become irritated or inflamed. There can be many different causes of this nerve irritation, including whiplash or other injury to the neck, injury to the back of the head, muscle spasm or recurrent muscle tightness, arthritis of the cervical spine, or other structural changes to the upper cervical spine. Infrequent causes of this type of headache can include diabetes, infection, or inflammation of different blood vessels.
What are the symptoms and signs of occipital neuralgia?
Although the symptoms of occipital neuralgia can vary from person to person, most patients will experience pain along the neck where it meets the skull, as well as pain along the back of the head. The pain might be one-sided or bilateral (located on both sides of the head). The pain might be sharp or stabbing, or feel like an electric shock along the nerve. Sometimes that pain is a dull aching or throbbing. The pain often can travel along the side of the head, sometimes as far forward as the forehead. There can be some symptoms that are frequently seen with migraine headache or other headaches, including sensitivity to light or sound, or scalp tenderness. Patients with this type of headache may have increased pain when moving their neck.
If the pain caused by occipital neuralgia travels along the side of the head to the face, it might initially be mistaken for a condition known as trigeminal neuralgia . However, physical examination and assessment of the history of the pain should reveal important differences that will help lead to the correct diagnosis.
Is there a test to diagnose this type of headache?
There is no test to specifically diagnose or confirm occipital neuralgia. The diagnosis is made on physical examination findings such as a marked tenderness to pressure along the occipital nerve; palpation of this region often will reproduce or worsen the pain that the patient is experiencing. If the patient has tenderness over the distribution of the greater occipital nerve is important in making this diagnosis. There may be some associated muscle tightness or spasm in the neck region. Some doctors perform a nerve block using a local anesthetic to see if this will eliminate or relieve the pain, helping to confirm the diagnosis. X-rays of the neck, CT scan, or MRI scan may be ordered if there is a concern that some underlying problem is causing the symptoms.
Medically Reviewed by a Doctor on 3/15/2017