You’re experiencing intense head pain, but you’re not sure if it’s a headache, migraine, or a lesser-known condition called occipital neuralgia. What are the most common occipital neuralgia symptoms that can lead to a correct diagnosis? We discuss 12 of the leading symptoms, and also talk about how this condition differs from migraines and headaches.

What causes occipital neuralgia? 

Its symptoms are similar to headache, but occipital neuralgia has a distinct origin that is often quite different than typical headaches and migraines. Occipital neuralgia is caused by irritation, inflammation, or injury to the occipital nerves. The occipital nerves run up from the base of the neck to the back of the skull, as shown below.

Occipital Neuralgia Symptoms |

John Hopkins Medicine explains how these enervate the head:

“Most of the feeling in the back and top of the head is transmitted to the brain by the two greater occipital nerves. There is one nerve on each side of the head. Emerging from between bones of the spine in the upper neck, the two occipital nerves make their way through muscles at the back of the head and into the scalp. They sometimes reach nearly as far forward as the forehead, but do not cover the face or the area near the ears; other nerves supply these regions.”

Occipital neuralgia occurs when these nerves are damaged. Most often, an isolated incident is to blame. Considerable trauma or injury to the head or neck can damage these nerves. This often occurs in a car accident or some other injury that causes whiplash.

Other common causes include overly tight neck muscles, arthritis, and diabetes. You can learn more about each of these in our post “8 Of The Most Common Causes Of Occipital Neuralgia.”

Since there are very specific occipital neuralgia causes, this condition is often confused with migraines or other severe headaches. True occipital neuralgia is rare. The American Migraine Foundation estimates that only 3.2 people out of 100,000 actually suffer from this condition. The following video talks about occipital neuralgia symptoms and causes in more detail.

What are the most common occipital neuralgia symptoms? 

To determine if you’re suffering from occipital neuralgia vs migraine or other types of headaches, it’s important to look at the symptoms of occipital neuralgia.

The most common occipital neuralgia symptoms include:

  1. Sudden, severe, and sharp head pain
  2. Pain that occurs most commonly behind the eye, at the base of the head, and on one side of the head
  3. Sensitivity to light
  4. Scalp tenderness
  5. Blurry vision
  6. Dizziness
  7. Vertigo
  8. Slurred speech
  9. Nausea
  10. Vomiting
  11. Tightness and pain in the neck
  12. Dental pain

Let’s talk about these occipital neuralgia symptoms in more detail.


Pain is the most characteristic symptom of occipital neuralgia, and often the most debilitating for patients. But pain, in and of itself, is a broad term. Occipital neuralgia pain in particular is often described as:

  • Episodic
  • Shocking
  • Shooting
  • Radiating
  • Aching
  • Burning
  • Throbbing
  • Intense
  • Piercing
  • Stabbing
  • Sharp
  • Spasms

While migraine sufferers may deal with dull and aching pain that doesn’t go away, occipital neuralgia produces a much more intense and (typically) shorter period of pain. Most commonly, this pain is felt most commonly:

  • Along the occipital nerves
  • At the base of the head, where the neck meets the skull
  • On the back of the head
  • Oftentimes on one side of the head, though it can also be bilateral (or both sides)
  • Behind one eye

All patients will experience this pain differently, however. Some do experience more throbbing, dull pain, while others feel pain and tenderness on the sides of the head or even forehead. Many patients may only feel pain for a few seconds, or a few minutes.


Sensitivity, in multiple forms, is another one of the most characteristic occipital neuralgia symptoms.

If you’re suffering from occipital neuralgia, you’ll typically feel severe tenderness directly over the affected occipital nerves. When these areas are touched or compressed, pain will flare up. This sensitivity might only last for a few seconds, but nerves