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I Suffer From Occipital Neuralgia

Occipital Neuralgia Treatment

Occipital Neuralgia is a medical disorder that presents with piercing, throbbing, or electric-shock-like chronic, aching pain in the upper neck, back of the head and behind the ears. Though mostly manifesting as head pain or upper neck pain, occipital neuralgia pain will sometimes present in the forehead, behind the eyes, or in the scalp. Occipital Neuralgia is usually unilateral, meaning it is only on one side of the head.

At the Brisbane Headache and Migraine Clinic, we have seen countless Occipital Neuralgia sufferers and use world-class techniques in identifying whether the neck and brainstem is the cause of the occipital neuralgia symptoms.

Once we commence with treatment, we expect a significant improvement to occur rapidly in 90% of our patients with Occipital Neuralgia and within the first 5 treatment consultations. Book today for an appointment for your non-medicated and non-invasive Occipital Neuralgia treatment.


Understanding your Headache

Occipital Neuralgia and its symptoms

With Occipital Neuralgia, the areas that are affected are directly associated with the areas innervated and supplied by the greater and lesser occipital nerves. These Occipital Nerves are the nerves that supply your brain with the information regarding sensation and pain, from the back of the head. This means that all sensation in the back of the head, neck and ears are reported to your brain via the Occipital Nerve.

Sufferers of Occipital Neuralgia are often extremely hypersensitive and report that slight stimuli, such as touching the neck, or the back of the head, can cause painful attacks. Some of these attacks last as little as seconds, or as long as minutes. 

Sometimes the sensation can feel like:

• A sharp jab
• An electric shock
• Chronic pain in the upper part of the neck, back of the head and behind the ears

It is not uncommon for Occipital Neuralgia sufferers to go undiagnosed for long periods of time or even misdiagnosed, as the symptoms presented can be similar to those of Migraine Headaches. One key differentiating factor between Occipital Neuralgia and Migraine is the length of episodes of pain.

Vertigo Headaches

Understanding Your Headache

What is the cause of Occipital Neuralgia?

Occipital Neuralgia has many causes, as the Occipital Nerves are one of the largest nerve structures supplying the head and neck. A common cause is the disruption of signals, causing the nerve to malfunction and produce pain signals when the touch sensation is activated.

Occipital Neuralgia may be the result of damage to the Occipital Nerve from surgery, brain lesions, stroke, or even trauma inflicted to the head and neck. Other nerve disorders such as Multiple Sclerosis can have a damaging effect on the Myelin Sheathing, which covers the nerve, and can cause Occipital Neuralgia.

How is Occipital Neuralgia Diagnosed?

Occipital neuralgia is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests. Healthcare providers inquire about symptoms, triggers, and perform gentle palpation to identify areas of tenderness during the physical exam. 

Imaging studies like MRI or CT scans may be ordered to rule out other causes of pain. Medical practitioners will commonly use a “nerve block”, where a local anaesthetic is injected into the occipital nerves to block pain messages from the spinal cord to the brain. Use of an occipital nerve block can temporarily relieve pain and aid in confirming the diagnosis. 

It’s essential to differentiate occipital neuralgia from other conditions like migraines or cervical spine disorders, which share similar symptoms. It is crucial that patients consult with a healthcare provider to accurately diagnose occipital neuralgia and appropriately manage its symptoms. 

With proper diagnosis and tailored treatment plans, individuals experiencing occipital neuralgia or other headache disorders can find relief and improve their overall wellbeing. 

Once you have been diagnosed, Brisbane Headache & Migraine clinic can develop personalised treatment plans based on your specific issues, focusing on alleviating symptoms and improving the patient’s quality of life.

About The Assessment Stage

What To Expect During The Assessment

1. Comprehensive and in-depth examination

We instigate an in-depth assessment to identify all possible related factors that could be causing your headaches or migraines. The upper cervical spine, in particular, is thoroughly examined to identify possible issues.

2. Ligamental stability and vertebral arterial tests

We undertake careful examination of neck ligaments and vertebral arteries, ensuring only the highest standards of patient safety and comfort.

3. Temporarily reproduce your headache and migraine symptoms

As a part of the treatment process, we apply gentle and selective stress to the upper cervical spine in order to reproduce headache symptoms, which subside after 20-30 seconds. This helps to identify and treat the cause of your headaches.

All you need to know about Occipital Neuralgia

Anatomy of the Occipital Nerve

The Occipital Nerve is actually a group of nerves that arise from between the second and third cervical vertebrae (C2/C3) interact with each other.The Greater Occipital Nerve innervates the semispinalis capitis muscle, as well as the scalp.

The Lesser Occipital Nerve innervates the scalp and behind the ears. The Third Occipital Nerve, also referred to as the Least Occipital Nerve innervates the semispinalis capitis muscle, a small area below the base of the skull, and the C2/C3 zygapophyseal joints.

Vascular causes of occipital nerve irritation

• Irritation of the C1/C2 nerve roots by an aberrant branch of the posterior inferior cerebellar artery

• Dural arteriovenous fistula at the cervical level

• Bleeding from a bulbocervical cavernomas

• Cervical intramedullar cavernous hemangioma

• Giant cell arteritis

• Fenestrated vertebral artery pressing on C1/C2 nerve roots

• Aberrant course of the vertebral artery

Neurogenic causes of occipital nerve irritation

• Schwannoma in the area of the craniocervical junction: schwannoma of occipital nerve

• C2 myelitis

• Multiple sclerosis

Osteogenic causes of occipital nerve irritation

• C1/C2 arthrosis, atlantodental sclerosis

• Hypermobile C1 posterior arch

• Cervical osteochondroma

• Osteolytic lesion of the cranium

• Exuberant callus formation after C1/C2 fracture

How is Occipital Neuralgia treated?

Treating Occipital Neuralgia

There is currently a very wide array of options for patients looking to treat occipital neuralgia. Some occipital neuralgia medications and treatment options include: 

• Over-the-counter painkillers
• Strong anticonvulsant/antispasmodic medications
• Steroid injections
• Botox injections
• Occipital Nerve Stimulation
• Surgical treatment (such as occipital release surgery)

These are some of the ways in which Occipital Neuralgia sufferers have attempted to rid themselves of the chronic headaches and painful attacks. In some cases, these ways can alleviate the symptoms of Occipital Neuralgia, however, despite utilising these treatment options, some sufferers may still find themselves having painful attacks. In some cases, certain surgical treatment options may carry the risk of permanent scalp numbness. 

If you are someone that feels like you’ve tried everything, have you had your neck assessed? Or, more importantly, have you had your brainstem evaluated in order to investigate the CAUSE of your symptoms, rather than simply masking them?

At the Brisbane Headache and Migraine Clinic, we have seen countless Occipital Neuralgia sufferers and use world-class techniques in identifying whether the neck and brainstem is at fault.

A thorough examination of the upper cervical spine is initiated to determine the severity of your sensitised brainstem.

Once treatment commences we expect a significant improvement to occur rapidly in 90% of our patients with Occipital Neuralgia and within the first 5 treatment consultations.

If you suffer from Occipital Neuralgia, or if you think it sounds like your symptoms and medication has given you no significant relief, then we believe that you should have a thorough examination of your neck and brainstem.

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