Occipital neuralgia is a distinct type of headache characterized by piercing, throbbing, or electric-shock-like chronic pain in the upper neck, back of the head, and behind the ears, usually on one side of the head. Typically, the pain of occipital neuralgia begins in the neck and then spreads upwards.
Some individuals will also experience pain in the scalp, forehead, and behind the eyes. Their scalp may also be tender to the touch, and their eyes especially sensitive to light. The location of pain is related to the areas supplied by the greater and lesser occipital nerves, which run from the area where the spinal column meets the neck, up to the scalp at the back of the head.
The pain is caused by irritation or injury to the nerves, which can be the result of trauma to the back of the head, pinching of the nerves by overly tight neck muscles, compression of the nerve as it leaves the spine due to osteoarthritis, or tumors or other types of lesions in the neck.
Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), and frequent lengthy periods of keeping the head in a downward and forward position are also associated with occipital neuralgia. In many cases, however, no cause can be found. A positive response (relief from pain) after an anesthetic nerve block will confirm the diagnosis.
“After suffering day in and day out for 32 years of my life, I was told I had occipital Neuralgia. And was given a large shot into the base of my skull every month for 3 years. And the shot did nothing. Than I was put on oral Gabapentin and for the first time in my life I have little to nothing for pain based off what I was dealing with. So thankful for it.”
I delivered packages for 32 years. 6 years ago I had such horrible neck pain and the dr did an xray and said bone spurs and take up to 16 ibuprofen a day and stretch. I had physical therapy, accupuncture, chiro, massage, traction and headaches, ear, neck and pain behind the eyes. I retired early because of this, then three weeks ago, slurred speech, dizziness, headache and finally went to a neurologist, he put me on gabapentin, and after 3 days, little pain, I am now on three times a day and ZERO pain pills…..zero for the first time in 6 years!!! The only side effect is a little sleepy but my energy level is way up and I can sleep wonderfully now. God bless the Neurologist and gabapentin. My life has changed for the best.”
I have chronic vestibular migraine (diagnosed by Neuro) and 8 months ago developed a new, constant pain in the back of my head which starts at the base of my skull and covers the full back of my head. I described my pain to my primary doc and she said it sounded like Occipital Neuralgia, then she looked at Neuro’s notes and it said I possibly had Occipital Neuralgia. Primary doc said to add Gabapentin to my migraine meds for the constant headache. She started me on 300mg a day, then upped me to 600mg. I have been on Gabapentin for 6 months. I recently had to increase to 900mg, then 2 weeks later to 1200mg, but I’m dealing with a lot of stress right now. I hope to be able to go back to 600mg. I have learned stress causes neuralgia flare-ups. This med has been great for me. Gave it a 9 not 10 since I had to increase it so much. The only side effects I had were bloating/fluid retention which resolved in the first month, and some sleepiness in the first few days.