Occipital neuralgia headache is often confused with a common headache due to the similarity of its symptoms, but nothing is further from the truth in terms of its causes and treatment.

Occipital nerve or posterior root of the second cervical root acts at two levels: motor, on the deep muscles of the neck and at a sensitive level, acting on the sensitivity of the scalp. This root emerges towards the surface at the level of the sub-occipital ridge, so it can be a very sensitive area when this nerve is irritated and very resistant to conventional treatments.

Occipital or Arnold neuralgia

It is a condition in which the nerves that run from the top of the spinal cord through the scalp, called the occipital nerves, are inflamed or injured. For this reason you may feel pain in the back of the head or at the base of the skull.

It is often confused with a migraine or other types of headache as the symptoms can be similar. However, the treatments for these conditions are very different, so it is important that you see your doctor for a correct diagnosis.

Why does occipital neuralgia occur?

Occipital neuralgia is the result of the pathophysiology of n. occipital major in 90% of cases, resulting in 10% caused by n. lesser occipital nerve, rarely being the third occipital nerve involved. As we have noted, these nerves lie beneath several deep muscle layers, so tension in the suboccipital muscles can irritate one or more nerves. It decreases the blood flow that provides nutrition and oxygenation to these occipital nerves, thus causing headaches the course of the affected nerve, which can often be accompanied by restrictions in the mobility of the head and neck. There are several treatment options to control the symptoms, which we will talk about later.

Symptoms and signs of Occipital Neuralgia Headache

When presenting, certain symptoms are triggered at the base of the skull, in the back of the head and in the innervation areas of the affected nerves, the most common symptom being pain in these regions, which can last a few minutes or even days.

Now, the characteristics of the most notable symptoms and signs of this condition are:

  • Pain in the back of the head that starts at the base of the skull. It is often unilateral.
  • Discomfort that can radiate from the back of the head to the eyes.
  • Sensitivity to light and sounds. (photophobia and phonophobia)
  • The painful sensation can be described as stabbing, electrifying, sharp and paroxysmal.
  • The pain gets worse when you move or rotate your head.

In addition to the symptoms mentioned above, pressure sensitivity in innervated areas and on the scalp is also possible .

What symptoms does Occipital Neuralgia produce?

The main symptoms are pain in the neck, often unilateral, with a feeling of stiffness when moving the head and neck. There may be a burning and stinging sensation, the patient feels as if their hair is being pulled, and it may affect only one side of the head. Depending on whether the affected nerve is right or left, it can be continuous or intermittent or caused by a specific position of the head.

Very often the patient can feel parallel sensations of dizziness, lightheadedness, instability and even some digestive symptom such as nausea.

Occipital Neuralgia Causes of headache and treatments

This headache may be the consequence of a rare disease such as syringomelia (cyst within the spinal cord), but in most cases it is the consequence of an alteration in the mobility of the vertebrae of the sub- occipital, atlas and axis. This mobility alteration in this region of the neck can be due to several situations:

  • Physical trauma such as a traffic accident.
  • Inadequate postural attitudes, such as spending a lot of time with the head facing downwards (at the computer, reading)
  • Stress and emotional tension that cause involuntary and constant tension, even when sleeping, of the muscles of the neck and the sub-occipital area.

Treatment may vary depending on the cause; for example: if it is traumatic, rest and some immobilization with a collar will be necessary, but in general there will always be benefit with:

  • Massage of the cervical muscles and even more so of the sub-occipital area: Self-massage of the neck and upper cervicals.
  • Diacutaneous fibrolysis or hook therapy to release the nerve root from possible adhesions: Physiotherapy treatment with fibrolysis or hooks for Arnold’s neuralgia.
  • Dry needling of the most affected neck muscles.
  • Osteopathic manipulations in order to restore cervical mobility.

Unfortunately, on many occasions, the treatment is reduced to taking muscle relaxants, anti-inflammatories and analgesics, with all its negative effects in the short, medium and long term and with very poor and short-lasting results.

In recent years, treatments based on botulinum toxin infiltrations have also been established to, for a few months, relax the muscles of the neck.

Occipital Neuralgia Complementary treatment to conventional therapies

The problem with these conventional treatments is that they only act in the area where the symptoms occur, but not on the origin of the problem, and this is especially relevant in Arnold’s neuralgia that is caused by stress, tension and accumulated anger.

Causes of Occipital Neuralgia. Vision from natural medicine

According to oriental medicine, these emotional situations directly influence organs such as the liver and gallbladder, and when these organs are unbalanced, they reflexively cause an increase in the tension of the never muscles (this is the explanation why the occipital neuralgia headache may be accompanied by dizziness, lightheadedness, unsteadiness, and nausea).

Therefore, it is necessary to add to the manual therapy mentioned above a nutritional treatment eliminating dairy products and derivatives, red meat, sausages, chocolate, coffee, oranges and tangerines for 3 or 4 weeks, and a treatment based on medicinal plants with the objective to protect the liver and gallbladder from the negative influence of the aforementioned emotional stresses.

Medicinal plants and natural treatment of Occipital neuralgia

In this treatment, manual therapy will be much faster, more effective and longer lasting. From this point of view, pharmacological therapy is counterproductive since not only does it not attack the cause, but it also enhances the attacks on the liver and gallbladder.

Surgical treatment of Occipital neuralgia headache

Surgical operation consists of releasing the strangulation of occipital nerve at the level of the nerve root in the occipital area. The surgical techniques that are most often used for this alteration are the partial disinsertion of the muscles that are inserted in the exit site of the nerve or that are crossed by this nerve (mainly the splenius capitis).

But more common are nerve blocks generated either with rhizolysis – by applying very intense heat to the nerve so that it stops working and transmitting sensitive or painful sensations – or by applying a corticosteroid together with a local anesthetic. to seek desinflammation of the nerve and so the pain subsides.

Another technique used is the injection of botulinum toxin at the insertion of the muscles that compress the nerve, thus reducing its contraction capacity and the compression tension around the nerve.

However, experience tells us that these measures do not have a good long-term result and that people only notice temporary relief, since over time the compression and, therefore, the pain return. Therefore, treatment must be more global and focused on the causes.

Key points about Occipital neuralgia

To end this article we can conclude:

  • Occipital neuralgia headache is a neurological problem caused by strangulation of said nerve in the occipital area.
  • Symptoms: pain in the neck, stiffness when moving the head, burning and prickling sensations, dizziness, lightheadedness, instability and even nausea.
  • Causes: physical trauma to the neck and head, inadequate posture, stress and emotional tension.
  • Treatment: massages, hook therapy, dry needling, osteopathic manipulations, botulinum toxin injections, medicinal plants, surgical.

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