(C2 Neuralgia; Arnold Neuralgia)
Occipital neuralgia is a headache with pain that starts in the back of the neck or head and moves to the scalp. It happens due to a problem with the two occipital nerves in the neck.
The exact cause is not always known. Other times it may be due to injury or irritation of the nerve from problems like:
- Trauma to the back of the head
- Neck muscles that are very tight or tense
- Pressure on the nerves from things like swollen blood vessels, gout, tumors, or cysts
Things that may raise the chance of occipital neuralgia are:
- Current or past neck injury
- Past surgery to the head and neck
- A spine, neck, or head that is not normal in structure
- Repeat stress or strain on the neck
The main problem is pain that starts in the back of the neck or head and moves up the scalp. It may be sudden, sharp, burning, or throbbing. The area may also feel numb. How long it lasts differs in each person.
The doctor will ask about symptoms and health history. A physical exam will be done. A neurological exam may also be done.
Images may be taken of the head and neck. This can be done with:
An occipital nerve block may be done. A needle with numbing medicine is inserted near the nerve. If it eases pain, then the nerve is likely the cause of the problem.
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The goal of treatment is to ease or stop pain. Any underlying causes will also need to be treated.
For most, neuralgia can be relieved with:
- Heat therapy, which may be dry, moist, or both
- Massage therapy
- Physical therapy to ease tense or tight muscles
Occipital neuralgia cannot always be prevented. Exercising the muscles of the neck may help.
- Headache—approach to the adult patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/headache-approach-to-the-adult-patient#TOPIC_IRG_HHZ_TKB.
- Occipital neuralgia. American Association of Neurological Surgeons website. Available at: https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Occipital-Neuralgia.
- Occipital neuraglia. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/occipital-neuralgia.
- Occipital neuralgia. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/occipital-neuralgia.
- Rimas Lukas, MD
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