Do you suffer from a distinct type of headache with chronic burning, throbbing, piercing, or electric-shock-like pain in the upper region of your neck, the back of your head, forehead, scalp, or behind your ears or eyes? – Symptoms which can appear on either one or both sides of your head? If so, then you may have occipital neuralgia [1].
Putting a Spotlight on the Condition
This very unwelcome state (which is not life-threatening), may occur spontaneously, or be due to a number of causes. It spreads upwards from the neck, where it affects various regions. On top of all the aforementioned symptoms in the last paragraph, some individuals experience sensitivity to light, and their scalp can feel tender if they lie on a pillow, or massage, brush, comb, or shampoo their hair. So you may be asking yourself, why are there so many different pain sites? The answer to this is that the latter are connected to the regions which are supplied by the lesser and greater occipital nerves. These stretch from the region where the spinal column attaches to the neck, up to the scalp at the posterior of the head [1].
If these nerves are injured or irritated, then you will experience pain. These issues are quite common, and can be due to numerous factors including: neck lesions; neck tumours; osteoarthritic-causing nerve compression of the spine, over-tight neck muscles causing nerve compression; and trauma to the posterior of the head. Moreover, occipital neuralgia is linked to holding the head in a downwards and forward position regularly, and for extended periods of time; vasculitis; inflammation of the blood vessels; diabetes; gout; and localised infection or inflammation. It is however, important to note, that in the case of many patients, no root cause can be found [1]. And this is one reason why it is crucial to have a consultation with a highly experienced Pain Specialist, who has spent many years within this field.
“There is not one test to diagnose occipital neuralgia. Your doctor may make a diagnosis using a physical examination to find tenderness in response to pressure along your occipital nerve. Your doctor may diagnose — & temporarily treat — with an occipital nerve block. Relief with a nerve block may help to confirm the diagnosis” [2]
Leading Pain Specialists with cutting-edge facilities such as at the London Pain Clinic, take a holistic approach to treatment, and after giving patients an in-depth examination, and reviewing their medical history, devise a personalised treatment plan, which normally includes non-surgical options. This may comprise several modes of treatment, and may include muscle relaxants, local nerve blocks, steroid injections with or without botox, and the latest anti-inflammatory pharmaceuticals. In the event that these modalities do not work, then your Pain Specialist will discuss surgical options.
References
[1]. National Institutes of Neurological Disorders and Stroke (2019). “Occipital Neuralgia Information Page”.
https://www.ninds.nih.gov/Disorders/All-Disorders/Occipital-Neuralgia-Information-Page#:~:text=Occipital%20neuralgia%20is%20a%20distinct,one%20side%20of%20the%20head.
[2]. John Hopkins Medicine. “What is occipital neuralgia?”.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/occipital-neuralgia
