In general millions of people in the world are going through common headaches due to many reasons. Out of the general common headaches, there is a distinct type of a headache known as Occipital neuralgia. This headache is characterized by piercing, throbbing, or electric-shock-like intolerable acute strain in the uppermost neck, behind of the head, and back the ears and happens typically on one side of the head.
Commonly Occipital neuralgia occurs in the neck and then spread towards the other common areas such as the back of the head, behind the ears and back of the head as well. The pain can occur in the scalp, forehead and behind the eyes for certain individuals.
Our senses and feelings in the back and top of the head are transmitted to the brain by the two greater occipital nerves which located on each side of the head. The two greater occipital nerves, emerge between bones of the spine in the upper neck and make their way through muscles at the back of the head and into the scalp.
Sometimes these nerves reach nearly as close as the forehead but do not cover the face or the area near the ears where the other nerves function in these regions. In occipital neuralgia, if an irritation takes place anywhere in one of these nerves, along with its course, can cause a shooting, zapping, electric, or tingling pain very similar to that of trigeminal neuralgia, but only with symptoms on one side of the scalp rather than in the face.
In occipital neuralgia, the pain can also shoot forward (radiate) toward one eye. Under these conditions in occipital neuralgia, the scalp becomes extremely sensitive to even the lightest touch in some patients, washing the hair or lying on a pillow is nearly impossible. In occipital neuralgia, numbness also can occur in the affected areas in other patients. Also, the specific area where the nerves enter into the scalp may be extremely tender.
Risk Factors of Occipital Neuralgia:
As per the modern science world, so far, the exact cause of occipital neuralgia has not been discovered yet, but some of the more common reasons listed below such as.
- Traumatic (damage) to the back of the head
- Due to overly tight neck muscles, Pinching’ (entrapment) of the nerve can occur.
- Developing of Osteoarthritis in the bones in the neck, compressing the nerve as it leaves the spine
- A rare condition of Lesions (e.g., bone cancers) in the neck.
What are the differences between Occipital Neuralgia and other headaches?
Occipital neuralgia headaches are frequently quite painful, starting with sharp, stabbing pain, but most patients respond well to treatment, and most of them recover.
In two ways, Occipital neuralgia is different from other types of headaches:
- The cause of the condition.
- The specific places where individuals feel the pain.
In most of the cases of general headaches, have shown common symptoms, such as high blood pressure, various medication allergies to sinus infections and many other potential triggers.
The symptoms of occipital neuralgia develop only when the occipital nerves which located in the 2nd and the 3rd vertebrae of the back of the neck, are irritated or injured.
Only when the areas touched by more significant, lesser and third optical nerves, the intensity of Occipital neuralgia pain will start to develop.
Since the occipital nerves run from the spine to the scalp, on each side of the head, sensitivity can develop anywhere along this route.
Occipital neuralgia causes:
Entrap nerves due to tight muscles at the back of the head, or the possible risk in the neck of a pinched nerve root (e.g., arthritis) or a prior injury or surgery to the scalp or the skull, can trigger a higher risk of Occipital neuralgia occurring spontaneously.
Visible symptoms of occipital neuralgia:
- The greater optical nerve involvement on one side is a known factor for the most common presentation for the higher, lesser, and or third occipital nerves Pain distribution.
- These episodes of attacks last a few seconds or minutes only.
- The Pain is severe in intensity, piercing, stabbing, or sharp.
- In the occipital nerves’ region, the patient can prominently feel unpleasant sensations.
- Most patients complaints of a Severe tenderness in the affected nerves.
How is Occipital Neuralgia diagnosed?
Scientists have found, distinguishing occipital neuralgia from other types of frequent headaches can be very tricky where the diagnosis has become a challenge indeed. Patients will face thorough evaluations including their family medical history, physical examination, and other diagnostical assessments. By documenting the symptoms, the medical examiner can analyze the severity that has affected the patient’s day to day life. The patient will be notified immediately to undergo the following tests in case of abnormal findings on the neurological exam.
Magnetic Resonance Imaging (MRI): A 3-dimensional diagnostical test which produces images of the human body structure with the technological help of using powerful magnets and computer technology; The results clearly show direct evidence of spinal cord impingement from bone, disc or hematoma.
Computed Tomography Scan (CT or CAT scan): With the help of computer read x-ray where a diagnostic image will show the shape and size of the spinal canal, its contents and the structures around it.
How common is Occipital Neuralgia?
According to modern science Occipital neuralgia is a rare condition. Hence the confusion of the actual diagnosis of other types of headaches such as migraine which causes inflammation of the greater occipital nerve on the affected side, repeatedly and predominantly involve one particular side of the back of the head. Commonly these patients diagnosed as having migraines that affecting the greater occipital nerve, rather than as having occipital neuralgia itself.
Occipital Neuralgia treatment:
01. Nonsurgical Options:
Overactive nerves can be relaxed and calmed by injecting three steroid injections either with or without botulinum toxin and prescribed suitable Medications. in some individual’s surgery may not require as they respond quite well to non-invasive therapy. However, in some patients, it’s not the case as they don’t show any signs of recovery whereas they definitely should stand for a necessary operation.
Various nonsurgical options are possible such as burning the nerve with a radio wave or eliminating the nerve with a low toxin dose. But so far these options didn’t receive the votes as the best choice due to many other complications can occur where the nerve can get permanently dead and, as a result, the scalp will get numb.
02. Surgical Options:
The most common procedure is decompressing of the greater occipital nerves along their path which is known an occipital release surgery.
In this outpatient surgical process, an incision will be made in the back of the neck by the surgeon to reach the greater occipital nerves, and the muscles and connective tissues that may be compressing them will be released. In most cases, the surgeon will repair the other nerves such as the lesser occipital nerves and the dorsal occipital nerves that may be contributing to the problem.
generally, it’s a two to three hours surgery which will perform while the patient is under general anesthesia. On the same day, the patients are being released to go back home, and within one to two weeks they will fully recover.
There are some cases where the pain returns after the occipital release surgery as it is a temporary solution. In these cases, the further operation to cut the greater occipital nerves can be performed after about a year, where this procedure is regarded as a last resort since it would result in permanent scalp numbness.
03. Home remedies:
In tight muscles, injury and injury, and stress cause occipital neuralgia. And there are known and effective home remedies to relieve the pain. Mainly it will help individuals to relieve their pain by using warm compresses, rest, massage and regular working out the pressure creating places in their necks. Reoccurrence of the painful condition can be prevented by guiding these individuals for Physical therapy which will work through the crisis phase of the occipital neuralgia and schedule them for regular daily exercises that they can follow.
Is occipital neuralgia curable?
It was discovered that occipital nerve blocks or conservative therapy are most excellent pain-relieving methods for most patients. One of the successful techniques is more invasive therapies for others. just like with many other physical conditions, each shows a widely different response to treatments. Headaches of this type do not lead to other neurological or nerve issues, even if untreated.
Is occipital neuralgia headache preventable?
The exact cause for occipital neuralgia is yet to be discovered in many cases. Hence prevention methods to this condition are yet to be found by the medical experts. So, it’s difficult to determine how to prevent this condition. However, recognizing factors that cause or contribute to muscle tension of the neck and avoiding circumstances which might lead to a neck injury is an excellent method of prevention.