The occipital nerves are a pair that starts from the second and third vertebrae of the neck, coursing along the side of the head, upwards to the skull all the way to the forehead. These nerves do not directly connect with any structure with in the skull but forms a continuous curved neural network that can affect any given area through which they pass. Their main function is to transmit to the brains, all the feeling from the back and top of the head. Any form of disturbance in these nerves causes Occipital Neuralgia.
Occipital Neuralgia Causes
The most common cause for an occipital neuralgia is trauma or an injury especially at the back of the head as this either damages the nerve or traps it between the muscles. It could also be caused due to spinal cord compression also called pinched nerves. Other lesser known causes are arthritis, surgery to the scalp, tumor, nerve legions, gout, diabetes, blood vessel inflammation or an infection in the spinal cord. According to a survey, this condition is more common among women than men.
Occipital Neuralgia Symptoms
The symptoms of occipital neuralgia are very similar to other medical conditions like trigeminal neuralgia, migraines, fibromyalgia or cervical disc disease. However pain in the upper part of the neck or base of the skull radiating towards the sides of the head is first sign of occipital neuralgia. These ‘headaches’ can occur on one or both sides of the head. They are extremely painful causing electric or shooting pain. The eyes are affected as they begin to burn and also become hypersensitive to light. In most cases the scalp becomes sensitive to touch, making even simple daily routines like combing and washing hair difficult. As the nerves become tender, sleeping or lying on the pillow becomes a difficult task to perform. Some patients even complain of numbness in the affected area and difficulty in moving the neck.
Occipital Neuralgia treatment & Diagnosis
Diagnosing this condition is a challenge to most doctors as the symptoms that presents itself also points to other medical condition. For example- a headache at the back of the head can also be a migraine. Occipital neuralgia responds well to treatment. Surgery is required only in extreme cases especially when this condition is caused due to pinched nerve. After initial tests like CAT scan and MRI, the doctor may advice massage and/or anti-depressants or nonsteroidal anti-inflammatory drugs or anticonvulsants along with ample rests. Oral medication and heat can also be taken in mild cases. Many doctors suggest that meditation along with rest increases the chances of recovering from this condition.
If conservative methods do not provide the desired results then ‘occipital nerve block’ becomes the next option. This method is most commonly in use today. This method of treatment is performed under local anesthesia as it is a painful procedure. An injection containing local anesthesia and a steroid is injected into the greater occipital nerve at the back of the head or above the neck. It is painful as the needle is injected into the deeper tissues. The effect is noticed immediately and remains effective from a few days to months, depending on the patient’s response. As this is a safe procedure, the injection can be taken again after about six months. The side effects are nil with only a slight pain in the affected area. Under rare circumstances infection or bleeding has been noticed. It should be noted that many doctors suggest narcotics. This does provide relief but because of its addictive nature and irreparable side effects, is no longer considered as a line of treatment.
Occipital nerve stimulation is a surgical procedure in which the nerve is electrically stimulated. This is a time consuming process as it is done in two phases. The first trial phase is performed under local anesthesia. The electrodes are placed over the affected nerve and secured in place. Then they are attached to an external stimulator. The patient is hospitalized for a few days wherein the patient decides if the treatment is working. With satisfactory results the wires are removed and the process shifts to the next phase. The second phase is performed under general anesthesia after a gap of a few weeks, to remove any doubt of an infection. The wires are permanently inserted and the battery operated electrodes are implanted into the skin. This is the last resort for treating occipital neuralgia.
The good news is that occipital neuralgia is not a life threatening problem.