Occipital neuralgia is a distinct type of headache characterized by sudden and recurring jabs of piercing, throbbing, chronic pain. The pain originates from base of the skull and often radiates to the back, front, and side of the head. It may also be present behind the eyes, in the upper neck, back of the head, and behind the ears, usually on one side of the head. It usually causes extreme light sensitivity to the eyes. The pain is caused by irritation or injury to the occipital nerves.
This condition is typically treated non-surgically, with the goal of alleviating the pain. However, if treatments such as physical therapy, massage, and pain medications are unsuccessful, it can be treated surgically at UPMC. Depending on the patient, surgeons may offer several possible approaches to relieve their pain.
Occipital neuralgia can be diagnosed by imaging studies such as CT and MRI scans.
Your physician will also ask you about your symptoms. These may include:
- sharp, stabbing head and neck pain that radiates from the base of the skull
- constant burning pain
- pain that is limited to one side of the scalp
- extreme sensitivity to light
Occipital neuralgia is typically managed without surgery, and may resolve with pain management techniques including physical therapy, massage, and medication. Surgical treatment depends upon the individual patient, and may include local injections and/or a microscopic cervical spinal approach for ligation of the dorsal roots of the top two vertebrae (C1 and C2) to relieve the pain.
At UPMC, we take a 360° Approach to treatment when evaluating each patient—looking at their conditions from every direction—to find the path that is least disruptive to the patient's brain, critical nerves, and ability to return to normal functioning. Our neurosurgical team may recommend a combination of surgical and non-surgical approaches to maximize the benefits of surgery while minimizing risks.
