Occipital Neuralgia Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Occipital nerve pain, also known as occipital neuralgia, is a headache caused by inflammation or injury to the occipital nerve. This nerve is at the back of the head to the neck.
Sufferers can feel pain such as throbbing pain, stabbing and sharp. Although very painful, occipital nerve pain is not considered life-threatening.
However, pain due to occipital nerve pain that is not handled properly can spread to the front and sides of the head, as well as the eyes which make the sufferer uncomfortable.
The distribution of pain follows the innervation of the greater occipital and third occipital, namely the sensory nerves from the upper neck to the back of the head.
In addition, pain due to occipital neuralgia is misunderstood as migraine or other headaches because the symptoms are similar.
So, are there any symptoms of occipital nerve pain that are typical and distinguish them from other headaches? Check out the explanation below.
Symptoms
Occipital nerve pain symptoms attack the head and neck area. Complaints of pain usually start behind one eye or on the back of the head.
Pain that appears can be in the form of stabbing, pressure, or electric shock.
The pain described is often like a migraine, so it’s not uncommon for sufferers to think this is a migraine complaint.
However, other specific symptoms of occipital neuralgia can include increased sensitivity to light and pain when moving the neck or touching the head.
Reason
The most common cause of occipital nerve pain is compression of the occipital nerve or stiffness of the muscles around it.
In addition, a person can also experience occipital nerve pain after experiencing trauma and injury to the head or neck.
Risk Factors
Occipital nerve pain can happen to anyone. However, there are several groups that are at risk of experiencing occipital nerve pain, including:
- Have a degenerative spinal disease
- Diabetes
- Gout
- Osteoarthritis in the spine
- Vasculitis (inflammation of the blood vessels)
Diagnosis
Given that the symptoms are similar to other types of headaches, such as migraines or cluster headaches, a neurologist needs to carry out a more in-depth examination to make a diagnosis.
For this reason, the doctor will conduct a medical interview, physical examination, followed by supporting examinations.
During the medical interview, the doctor will ask about complaints of headaches that are felt and other accompanying symptoms.
After that, the doctor will continue with a physical examination by placing pressure on the area behind the patient’s head, where there is the occipital nerve.
The goal is to find out whether the location is where the pain appears.
A tingling sensation may occur when the doctor presses or taps around the occipital nerve.
When the sufferer lies on a pillow and looks up or turns the neck, pain can also appear.
Doctors can also suggest investigations to help establish the diagnosis of occipital nerve pain.
The recommended supporting examinations for diagnosing nerve pain are:
- X-ray, to help find out if other conditions are involved, such as arthritis or problems in the upper spine
- CT-Scan, to help see if there are pathological or degenerative abnormalities
- MRI is an important examination because it can more clearly assess the tissue around the neck and occipital nerves
- Diagnostic block, injecting a local anesthetic into the occipital nerve to help confirm the diagnosis. On the other hand, this method also acts as a therapy for occipital nerve pain.
- However, this test can give false positive results in cases of migraine and cluster headaches
Treatment
The way to deal with occipital nerve pain is in the form of conservative, namely administration of drugs or with interventional procedures.
Generally, doctors will provide nerve pain relievers, such as:
- Antidepressant class: amitriptyline , nortriptyline
- Anticonvulsants: carbamazepine, gabapentine , pregabalin, phenytoin
- Opioids and NSAIDs
Apart from taking medication, medical procedures can also be performed to treat nerve pain, such as:
- Injections into the nerves using anesthetic drugs in combination and/or without steroids to reduce pain
- Botulinum toxin injection to help reduce inflammation
- Radiofrequency ablation to help reduce pain by using a low-intensity electrical induction method around the nerve
- Surgery such as occipital nerve stimulation, spinal cord stimulation, and C2,3 ganglionectomy
Prevention
In order to avoid occipital nerve pain or occipital neuralgia, there are several things you can do, such as:
- Adequate rest (7-8 hours a day)
- Meet balanced nutritional needs
- Avoid consuming alcohol
- Avoid smoking
- Avoid stress
- Do stretches so that the neck muscles are not stiff
Complications
Occipital nerve pain is not actually life-threatening. However, this complaint can cause a decrease in one’s productivity.
In addition, complications usually arise from interventions performed, for example in the form of infection in surgical scars or body parts that were performed or wound adhesions.
When to See a Doctor?
Immediately go to the doctor if the above symptoms of occipital nerve pain appear.
If complaints of headache that do not improve are accompanied by fever, double vision or other visual disturbances, weakness, or decreased consciousness, immediately go to the nearest health facility.