Do you suffer from severe head pain at the base of your skull, or behind your eyes? When related to other symptoms, like blurry vision or light sensitivity, it could be a sign of occipital neuralgia. Treating this painful condition can be difficult because it is often misdiagnosed as typical migraine or headache pain. If you’re looking for information on how to treat occipital neuralgia pain, consider a mix of complementary therapies, such as chiropractic or massage, along with interventional treatments, like occipital nerve blocks. In this post, we cover 21 occipital neuralgia treatments that range from at-home options to surgical options for severe cases.
What is occipital neuralgia?
Occipital neuralgia is a form of sharp and shooting head pain that radiates from the top of the spinal cord to the scalp. It is caused by injury or damage to the occipital nerve, or compression to the nerve root. There are two types: greater and lesser. EPainAssist.com explains that the greater form is:
“A common type of posttraumatic headache, but is also seen in patients without injury. The pressure, aching, stabbing, or throbbing pain may be in a nuchal-occipital, temporal, parietal, frontal, periorbital, or retro-orbital distribution. The headache may last for minutes or hours to days and can be unilateral or bilateral.”
Lesser, on the other hand, refers to pain that occurs laterally over the head. The following image shows where the occipital nerve is situated in relation to the spinal cord, as seen from the back of the skull.
How to treat occipital neuralgia comes down to understanding its causes. These are many. Occipital neuralgia causes may include:
- Injury after car accident
- Overly tight neck muscles
- Compressed nerves in the neck, due to osteoarthritis or other conditions
- Vasculitis, or blood vessel inflammation
- Overuse injuries caused by keeping the head in a down or forward position
Occipital neuralgia symptoms include:
- Chronic headaches
- Pain behind the eye, on one side of the head
- Blurry vision
- Dental pain
- Migraine symptoms
- Sensitivity to light
- Scalp tenderness
- Pain and tight muscles when moving the neck
How to treat occipital neuralgia, a video primer
For more information about this condition and an introduction to basic treatments, check out the video below. We’ll discuss each of these options in detail below.
Living with occipital pain
This is a rare condition. The American Migraine Foundation reports that it only affects 3.2 people out of 100,000 every year. John Hopkins Medicine goes on to explain that though many people will experience migraine pain in the back of, and on one side of the head, the majority of these patients don’t actually suffer from this condition. They note:
“We generally refer to these patients as having migraines involving the greater occipital nerve, rather than as having occipital neuralgia itself.”
After reviewing a complete medical history and any imaging scans, they can make a diagnosis. For those three people who are diagnosed with this condition, however, the pain can be life-changing. Figuring out how to treat occipital neuralgia is a critical goal. But further, many of the methods we discuss in this post for how to treat pain can also be used to reduce and relieve pain in patients who are suffering from migraines involving the greater occipital nerve.
1. Start with your diet
If you’re wondering how to treat occipital neuralgia, or chronic pain conditions of any kind, it always pays to look first at your diet. Empowher.com explains:
“Greater attention to diet, and in particular, B vitamins may help relieve occipital neuralgia by boosting the body’s ability to heal itself. Vitamin B12 aids normal nervous system development and nerve regeneration so some patients take a B12 supplement. Having plenty of fatty acids like fish oils or flax seed oils can be helpful in reducing inflammation around the nerves.”
Other general recommendations for a pain-friendly diet include:
- Staying adequately hydrated
- Eating fresh and unprocessed foods as much as possible
- Reducing your sugar intake
- Incorporating more magnesium into your diet, or take as a supplement
2. Try at-home relaxation methods
Put simply, stress increases pain levels. For milder cases, therefore, start with at-home methods to reduce tension and stress in your body. WebMD recommends resting in a quiet room or applying heat to sore neck muscles. These simple methods likely won’t cure these types of headache, but they can help reduce pain on a day-to-day basis.
3. Incorporate meditation into your day
Meditation is an important treatment method for all chronic pain patients. It incorporates both mind and body approaches to healing, creates relaxation, and can help you more fully understand your pain. Learn more about all the benefits of meditation in our post “Easing Pain And Stress With Mindfulness Meditation.”
4. Book a massage
If simple relaxation doesn’t cut it, take it a step further. A massage can drastically help you reduce tension that could be causing your pain. You can:
- Ask your partner for a massage
- Perform a solo neck and jaw massage
- Spring for a professional massage (look for cheaper massage deals on Groupon!)
5. Learn more about cranial osteopathy
Cranial osteopathy is an advanced form of massage that targets the head specifically. Health expert, Andrew Weil, MD, explains:
“My recommendation would be cranial osteopathy, an osteopathic manipulative technique that I’ve found extremely useful for a wide range of problems, from headaches to hyperactivity in children, disturbed sleep cycles and asthma. Cranial osteopathy works through very gentle pressure applied with the hands to the head. The aim is to free up restrictions in the movement of the cranial bones and allow the subtle natural rhythms of the central nervous system to express themselves in a balanced fashion.
Find a list of physicians trained in osteopathic manipulation at The American Academy of Osteopathy.
6. Consider how you’re sleeping
Too little sleep, too much pain. We’ve talked on the blog before about how sleep issues can create more pain the following day. This can then cause sleep issues the next night. It’s an awful cycle that requires a big effort to help break. The Neuro Headache Specialist takes on the topic of sleeping with occipital neuralgia, noting:
“Sometimes headaches are caused by pinched occipital nerves and by adjusting the position you sleep in can reduce the pain. Do not place your neck in a crooked position as this can cause your head and neck muscles to stiffen and contract. This position will apply pressure to the occipital nerve. Use a pillow that supports your neck but won’t allow your head to be higher than your neck.”
You can find some of the best neck pillows in our post “21 Of The Best Pillows For Neck Pain.”
7. Practice yoga for occipital neuralgia pain
For pain associated with the occipital nerve, yoga could help. This centuries-old practice is deeply healing and restorative. LiveStrong.com recommends three yoga poses that could help with occipital pain, including:
- Sub-occipital neck stretch
- Neck rotation
- Neck extension and flexion
Four more yoga for neck pain poses include the following.
8. Do occipital strengthening exercises
TheNest.com recommends the following strengthening exercise for occipital pain: the chin tuck.
“To strengthen the occipital muscles, the chin tuck is an effective exercise to prevent neck pain and can be performed several times throughout your workday. If you repeat the chin tuck on a regular basis, it can improve your posture. Sit upright with your head and spine aligned. Place your fingertips on the front of your chin, keeping your mouth closed. Maintaining a straight neck, exhale and gently press your chin backward. Allow your head to move under the pressure until you feel the pull of your occipitals at the base of your skull. You may feel as if you’re creating a double chin, which means you’re doing the stretch correctly. If the muscles in the back of your neck are extremely tight, avoid stretching beyond your threshold of pain.”
9. Try non-steroidal anti-inflammatory drugs (NSAIDs) for acute cases
NSAIDs, like aspirin, may be appropriate for short bursts of mild to moderate occipital neuralgia pain. Spine-Health.com notes that NSAIDs can reduce and relieve inflammation that could be leading to head pain. Always be aware of how much of these medications you’re taking, however, as they can cause gastrointestinal or cardiovascular side effects.
10. Use topical medications for nerve pain
Topical medications are applied on the skin as a gel or cream. While they may not work as well as some of the interventional options listed below, they can help reduce sensation in affected areas. And, topical medications don’t have many of the same side effects or run the risk for addiction or abuse that other medications have. Timothy C. Hain, MD, on dizziness-and-balance.com, recommends talking to your doctor about the following:
- EMLA cream
- Ketamine lotion
- Lidocaine patch
11. Review your medication options for how to treat occipital neuralgia
This condition doesn’t typically respond well to medications. However, if you’re suffering from migraine pain that’s related to the occipital nerve, taking medications along with other conservative methods could be the best occipital neuralgia treatment for you. Drugs.com lists and reviews the medications that are related to treatment.
Your medication options may include:
- Anti-convulsant medications
- Muscle relaxants
As BlueCross BlueShield explains, many patients do use medications while employing other treatments. This approach to pain management is at the cornerstone of the field. If your pain hasn’t responded to medications or other at-home options, read on for more information about interventional and complementary chronic pain treatments.
12. Discuss behavioral modification therapy with your doctor
HealthGrades.com recommends behavioral modification therapy, in conjunction with medication. This type of therapy focuses on changing undesirable or negative behaviors that could be leading to pain.
Pain isn’t only in the body. It also lives in the brain. By tackling the pain from both the body and mind aspects, you can work towards less pain overall.
13. Try out acupuncture
Acupuncture is a minimally-invasive procedure. It aims to relieve pain by inserting small needles into specific areas in the body. A practitioner places these needles at known acupuncture sites that are either at the site of pain, or distantly contributing to it.
The pain relief associated with acupuncture is typically attributed to endorphins, or pain-relieving hormones, being released into the body. Acupuncture can be a great complementary option in coordination with other treatments.
14. Incorporate physical therapy into your routine
Physical therapy, either focused on massage or muscle realignment, can be one of the best conservative occipital neuralgia treatments. Even better, physical therapy has little to no side effects so it can be used successfully with other interventions.
LiveStrong.com explains another benefit of physical therapy:
“Another effective form of physical therapy is completing back and neck exercises. These exercises will help to strengthen the muscles in your back and neck and allow for better posture. Poor posture, specifically being hunched over and bending your neck down, can put pressure on your nerves and lead to headaches.”
Professional Rehabilitation Services gives a more in-depth explanation of physical therapy approaches your therapist may use.
15. Talk to a chiropractor
Chiropractic care is a highly-effective option for how to treat occipital neuralgia. Through multiple cervical spine manipulations, a chiropractor can help reduce tension and pain in this area. Like physical therapy, chiropractic care has little to no side effects. Learn more about the benefits of chiropractic care in our post on the topic.
16. Find relief with occipital nerve blocks
For moderate to severe cases, occipital nerve blocks are often the best method for finding relief for patients. The National Institute of Neurological Disorders and Stroke, part of NIH, recommends this option as a front-line treatment after at-home or conservative treatments haven’t worked.
Occipital nerve blocks involve injecting a local anesthetic and steroid into the area of the occipital nerve. This injection can block your pain sensations coming from the occipital nerve. It can be used as either a therapeutic option, or as a diagnostic test to confirm occipital nerve pain.
17. Talk to your doctor about radiofrequency ablation
As TreatingPain.com explains, severe cases may be treated with radiofrequency neurotomy (another name for ablation). This procedure involves interrupting the sensory nerve supply to a joint through the use of thermal denervation. Studies on radiofrequency neurotomy have shown that patients can experience pain relief for up to 15 months, or even longer, after a procedure.
Our doctor explains how a radiofrequency ablation procedure takes place.
18. Read more about Botox for headaches
When you were wondering how to treat occipital neuralgia, you probably didn’t consider Botox.
Botox injections for headaches are a fairly new area of treatment, but there is some research backing this option. A study from Current Pain and Headache Reports found that patients found significant headache pain relief during a four-week period following Botox injections.
19. Try prolotherapy
Prolotherapy is a regenerative injection therapy that may help patients who haven’t responded to nerve blocks or other more conservative treatments.
Ross A. Hauser, MD, explains more about this treatment option.
20. For hard-to-treat cases, consider surgery
When considering how to treat occipital neuralgia, surgery should always come after you have tried other options with no relief.
The American Association of Neurological Surgeons discusses two options for surgical treatments for extreme and severe cases of occipital neuralgia: microvascular decompression and occipital nerve stimulation. On their website they explain the following about these two procedures:
“Microvascular decompression involves microsurgical exposure of the affected nerves, identification of blood vessels that might be compressing the nerves and gentle displacement of these away from the point of compression. ‘Decompression’ may reduce sensitivity, and allow the nerves to recover and return to a normal, pain-free condition… Occipital nerve stimulation uses a neuro-stimulator to deliver electrical impulses via insulated lead wires tunneled under the skin near the occipital nerves at the base of the head. The electrical impulses can help block pain messages to the brain.”
21. Learn more about your options for how to treat occipital neuralgia
To find more information about how to treat occipital neuralgia, check out PatientsLikeMe.com, which is a patient-driven site that compiles data from multiple patients suffering from a condition. On that site, you can see what treatments have worked for other patients and get feedback on any treatments you’re considering.
Likewise, you can talk to a specialized pain doctor who can discuss all of these options with you in more detail. Pain doctors are trained to treat pain with a comprehensive approach, bringing in mind and body practices to help you successfully reduce your pain. They can also help you diagnose your pain, suggest treatments that work best with your lifestyle, and connect you with support groups for dealing with pain.
To find a pain doctor in your area and get more information on how to treat occipital neuralgia, click the button below.