Occipital neuralgia is a different type of headache that is characterized by a throbbing and chronic pain like electric shock in the upper part of the neck behind the ear and back of the head, usually on one side of the head.
Cause
Typically, occipital neuralgia pain begins in the neck and then radiates upward. Some individuals may also have pain on the scalp, forehead, and behind the eyes. The scalp of these patients may be sensitive to touch, especially their eyes may be sensitive to light. The location of the pain is related to the areas supplied by the large and small occipital nerves. These areas are the scalp, the back of the head and the upper part of the neck. Pain can be caused by irritation or injury to the nerves, osteoarthritis, compression of the nerves by overly tight neck muscles, trauma to the back of the head. Tumors or lesions of the neck are other causes. Localized inflammation or infection, gout, diabetes, vasculitis, and frequent long periods of downward and forward holding of the head (improper posture) are also associated with occipital neuralgia. In many cases, however, no cause may be found. A positive response (pain relief) after an anesthetic nerve block will confirm the diagnosis.
Treatment
Treatment is usually symptomatic and includes massage and rest. In some cases, especially for severe pain, antidepressants can be used. Other treatments may include local nerve blocks and steroid injections directly into the affected area.
Surgical treatment
It should be performed if the pain becomes chronic or does not benefit from conservative treatment and is very severe. Microvascular decompression and neurostimulation are two different treatment methods. With microvascular decompression, the membrane layer called fascia on the nerve under the scalp is cut and the nerve is relieved from pressure.
