What is Occipital Neuralgia? Occipital Neuralgia Causes, Symptoms and Treatments for Occipital Neuralgia

Occipital neuralgia affects an estimated three out of every 100,000 people every year. It's a complex condition that's difficult to diagnose because occipital neuralgia symptoms can often be mistaken for a migraine. Occipital neuralgia does not have a cure. The right treatment and pain management plan can help sufferers live a normal life and manage occipital neuralgia symptoms. There are several treatment options available, and there are many natural ways to help alleviate the pain and discomfort caused by occipital neuralgia. In this blog, we will talk about occipital neuralgia causes, symptoms, and treatments for occipital neuralgia.

What is Occipital Neuralgia?

Occipital neuralgia is a condition that occurs when the occipital nerves – the nerves that run along the scalp – become inflamed or injured. When this happens, it can cause a variety of symptoms, including throbbing pain along the back of the head, upper neck, or behind the ears.

Other symptoms include burning, aching, and shooting pain that radiates from the base of the skull through the scalp on one or both sides. Some people also experience pain behind the eyes on the side of the head affected by pain. Movement can also trigger pain. 

The pain may feel similar to a migraine or cluster headaches.

Occipital Neuralgia Causes

Occipital neuralgia is primarily caused by injuries, pinched nerves, or muscle tightness in the head or neck. It can be either a primary or a secondary condition. A secondary condition means that there is an underlying condition causing the occipital neuralgia. 

Although there are many underlying conditions that can cause occipital neuralgia, the condition is usually attributed to chronic neck tension or pinched nerves in the neck.

Conditions that may cause occipital neuralgia to include:

  • Cervical disc disease
  • Osteoarthritis in the upper neck
  • Diabetes
  • Gout
  • Infection
  • Blood vessel inflammation
  • Compression of the occipital nerves

What’s the Difference Between a Migraine and Occipital Neuralgia?

what is occipital neuralgia occipital neuralgia causes symptoms and treatments for occipital neuralgia woman holding temples with a headache

The symptoms of occipital neuralgia can be very similar to a migraine. It’s not always easy to differentiate between the two, and that’s why it can be challenging to diagnose this condition.

However, there are some key differences between these two conditions.

Affected Area

Occipital neuralgia can make it painful to even touch the back of the upper neck and scalp. While migraines can do this, they typically don’t. 

Type of Pain and Duration

Migraines cause throbbing, dull, and long-lasting pain. Occipital neuralgia, on the other hand, causes short bursts of sharp pain. Both conditions can affect one side of the head.


Migraines have many triggers, from bright lights to eye strain, strong smells, loud noise, and even low blood sugar. Occipital neuralgia, on the other hand, the primary triggers are head movement and touching the neck or head.


Migraines have very distinct visual symptoms, and not every person experiences them. Migraine with an aura, which isn’t common, causes blind spots and flashing lights. With occipital neuralgia, visual symptoms include light sensitivity, blurry vision, and pain behind the eyes.

In both cases, vision effects may last as long as the pain and can make it difficult to carry out everyday tasks.

Treatments for Occipital Neuralgia

Treatment can help alleviate the pain, but there is no cure for occipital neuralgia. Surgical and non-surgical treatments are available. 

Diagnosis can be tricky simply because there is no single test to look for occipital neuralgia. Your doctor may perform a neurological exam and a physical examination to look for any abnormalities or signs of this condition.

If a physical exam doesn’t give a clear answer, your doctor may order an MRI test or a CT scan to get a better look. Occipital nerve blocks may be used to confirm the diagnosis.

Treatments can be surgical or non-surgical, but generally, doctors recommend trying non-surgical methods first. 

Surgical Treatments

There are three main surgical treatments available for occipital neuralgia:

  • Spinal cord stimulation: For this procedure, stimulating electrodes are placed between the spinal cord and vertebrae. Electrical impulses block pain messages from the spinal cord and brain.
  • Occipital nerve stimulation: Similar to the previous procedure, but the electrodes are instead placed under the skin close to the occipital nerves. The advantage of this procedure is that it’s minimally invasive and won’t damage surrounding nerves. 
  • CS, 3 ganglionectomy: This procedure removes the second and third cervical sensory dorsal root ganglion. While studies show that 95% of people saw immediate relief with this procedure, only 60% still had relief one year later.

Non-Surgical Intervention

When treating occipital neuralgia, non-surgical treatments are usually the first options. Non-invasive treatments may include:

  • Oral medications, such as muscle relaxers, anti-inflammatory medications, and anticonvulsants.
  • Heat therapy, such as heating pads.
  • Massage or physical therapy.
  • Botox injections to reduce nerve inflammation.
  • Percutaneous nerve blocks, which are injections that can be used to treat and diagnose the condition.

Many sufferers of occipital neuralgia find that over-the-counter pain relievers aren’t enough to resolve the problem. Prescription painkillers, with careful management, may bring some relief. However, there is a risk of addiction, and other non-surgical options may be a better option over the long-term.

A 2014 study found that deep tissue massage was just as effective as nonsteroidal anti-inflammatory medications for alleviating pain. Massage and heat can help alleviate muscle tension that can be a major contributor to occipital neuralgia. 

what is occipital neuralgia occipital neuralgia causes symptoms and treatments for occipital neuralgia woman in white tank top holding back of neck

Natural Support for Occipital Neuralgia

While there is no cure for occipital neuralgia, there are many natural supplements that can help bring some relief, including:


Although turmeric is best known for its culinary uses, this spice is also used for medicinal purposes. Turmeric root, like ginger root, has potent anti-inflammatory effects and may also help with pain relief.

The anti-inflammatory and pain-relieving effects of this spice are mainly due to curcumin, the primary compound in this root.

Fish Oil

Oil from fatty fish, like salmon, sardines, and mackerel, are rich in omega-3 fatty acids, which can be anti-inflammatory. There is some evidence that omega-3 fatty acids can be just as effective as over-the-counter pain relievers at reducing pain. 

Eating fatty fish is a great way to boost your omega-3 intake, but if you’re not a fan of seafood, high-quality fish oil supplements can work just as well.

B Vitamins

B vitamins play a critical role in immune and nervous system health. While they are found in abundance in many foods, you may need supplements to help increase levels enough to make a difference. Quality B vitamin supplements can help bridge the gap.


Eating foods that are rich in magnesium or taking a magnesium supplement can help alleviate pain and relax muscles. There is some evidence that low levels of magnesium can cause muscle cramps. 

Magnesium-rich foods include wheat bran, blackstrap molasses, kelp, cashews, almonds, spinach, and more. You can also take a daily magnesium supplement. 

Alpha Lipoic Acid

Alpha lipoic acid is a sulfur-containing fatty acid that’s found in every cell of the body. It’s also a powerful antioxidant. It is sometimes prescribed for pain, as it can support nerves from damage. For many years, alpha lipoic acid has been used in Germany to treat diabetic peripheral neuropathy, which causes nerve damage in the limbs. 

What is the Outlook for Occipital Neuralgia?

Fortunately, occipital neuralgia is not a life-threatening condition. However, it can still cause tremendous discomfort and affect your quality of life. 

The right treatment regimen and pain management plan can help you live a normal life. When occipital neuralgia is a secondary condition, meaning that there is an underlying condition, symptoms can improve significantly if the medical condition is treated.

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