Occipital Neuralgia: An Uncommon and Uncomfortable Condition

There are more than 150 types of headaches, and one of the more uncommon is a disorder called occipital neuralgia. While isolated occipital neuralgia may not be common, migraines are — they affect more than 10% of the world’s population — and the two types of head pain can collide.

To help shed some light on occipital neuralgia, on its own and in relationship to migraines, board-certified neurosurgeon Dr. Aizik L. Wolf and the team here at Miami Neuroscience Center present the following.

True occipital neuralgia

To explain what true occipital neuralgia is, we have to take a quick dive into some anatomy. Your occipital nerves include three different nerves, including your:

1. Greater occipital nerve (GON)
2. Lesser occipital nerve (LON)
3. Third occipital nerve (TON)

These three nerves are formed by the C2 and C3 spinal nerves that exit your spine in your neck. These nerves travel up into the back of your head and are responsible for sensation in your scalp, but they don't reach your face.

When you have occipital neuralgia, one of these nerves is compressed, which can lead to pain (and numbness) in your scalp, usually on one side. It can also feel like the pain is coming straight through to the back of one of your eyes. Also, your scalp can become very tender, and even the slightest touch can send shooting pain through.

In 90% of cases, occipital neuralgia stems from a problem in your GON, it involves the LON 10% of the time, and it rarely includes the TON.

Causes of occipital neuralgia

The precise cause of occipital neuralgia is compression in one of the occipital nerves, which can occur due to:

• Arthritis or degenerative disc disease in your cervical spine
• Tight neck muscles
• Trauma to your spine
• Trauma to the occipital nerve (a laceration or surgery on your scalp)

Another reason why you may experience occipital nerve pain is due to migraines. There are a couple of reasons migraines and occipital neuralgia are linked. First, the symptoms are very similar — pain on one side of the head. 

Second, when you have repeated migraines, inflammation around your occipital nerves can lead to the same symptoms as occipital neuralgia. This nerve compression occurs only during the migraine, and, once the inflammation subsides, it leaves your occipital nerves alone.

Diagnosing and treating occipital neuralgia

As you can imagine, diagnosing a rare condition like occipital neuralgia is complex. After reviewing your symptoms, we run some tests to determine whether you have isolated occipital neuralgia and what’s causing the condition.

From there, we can discuss treatment options, and we assure you there are solutions to relieve your pain.

Before we get ahead of ourselves, the first step is to come to see us so that we can assess your head pain. To get started, please contact our office in South Miami, Florida, to set up an appointment.