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I have just been diagnosed with occipital neuralgia.  I have been a headache sufferer for almost 50 years.  I have been treated for migraine, tension headache, TMJ syndrome, sinus headaches and some I can't even remember. When I do get a headache is it most always on the left side and where I really feel the pain is behind the left eye.  I often get very sick to my stomach with these.  I have always referred to them as my sick headaches. Do you have any information on occipital neuralgia? As you know during a visit with a doctor all of the information that is being passed on to the patient is usually new to them and not a whole lot of it is remembered.

I would appreciate any information that you can give to me.

Thanking you in advance,

Karla

REPLY:
Karla,

Occipital neuralgia (ON) is a chronic pain disorder caused by irritation or injury to the occipital nerve, or surrounding area, located in the back of the scalp. Individuals with the disorder experience pain originating at the nape of the neck. The pain, often described as throbbing and migraine-like, spreads up and around the forehead and scalp. Occipital neuralgia can result from physical stress, trauma, or repeated contraction of the muscles of the neck.

When the pain of ON is severe, the treatment is often local anesthetics such as Lidocaine or Marcaine injected  or a long-acting anti-inflammatory subcutaneously. When this treatment is successful, the effects generally last for weeks or, rarely, perhaps months. Some of the same medications used for the prevention of tension headaches, cluster headaches, and Migraine are sometimes helpful for ON as well. In addition, physical therapy for the neck is sometimes helpful. Word on the street is that so-called neck “tension” headaches often are migraines or migrainous

On what basis were you diagnosed with occipital neuralgia, and by whom? Since you don’t mention pain at the nape of your neck or back of your head, your pain doesn’t seem to fit the pattern of ON.

You also mention treatment for “sinus headaches,” but studies have shown the vast majority of so-called sinus headaches to be Migraine. You may want to consider a second opinion from a qualified headache and Migraine specialist.

Wishing you the best,
John Claude Krusz and Teri Robert

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Teri Robert

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