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Have a headache

Headaches in back of head

Headache on one side

Hand tingling

Headache on the side of my head

Headaches with sharp, electrifying pain

Tingling

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What is Occipital Neuralgia?

Occipital neuralgia is a rare type of headache characterized by intense, brief, throbbing, electric-shock-like pain in the back of the head or behind the ears. It can occur on one or both sides of the head, and is thought to result from pinching of a nerve by scalp or neck muscles, neck injury, as well as neck or skull base surgery.

Typical Symptoms of Occipital Neuralgia

Diagnostic Questions for Occipital Neuralgia

Your doctor may ask these questions to check for this disease:

  • Do you have pain at the back of your head?
  • Do you have a headache?
  • Is your headache on one side only?
  • Do you feel tingling or prickling sensations in your skin?
  • Do you have an earache?

Treatment of Occipital Neuralgia

Treatment options include injecting numbing and inflammation-reducing medications in the area of the nerve (occipital nerve block), medications to reduce nerve pain, as well as rest/neck immobilization, applying heat/ice to the neck, or massage.

Reviewed By:

Benjamin Kummer, MD

Benjamin Kummer, MD (Neurology)

Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.

Shohei Harase, MD

Shohei Harase, MD (Neurology)

Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.

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Content updated on Mar 31, 2024

Following the Medical Content Editorial Policy

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Symptoms Related to Occipital Neuralgia

Diseases Related to Occipital Neuralgia

FAQs

Q.

Torticollis? Why Your Neck Is Stuck & Medically Approved Steps

A.

A stuck or tilted neck is often torticollis, usually from muscle spasm or strain, and most cases are temporary and improve with gentle movement, heat, short-term OTC pain relief, posture correction, and, if needed, physical therapy or prescribed treatments. There are several factors that can change your next steps, like fever with neck stiffness, severe headache, neurological symptoms, recent trauma, persistent or recurrent pain, infant head tilt, or medication side effects. For specific red flags, timelines, and step by step care you can start today, see the complete guidance below.

References:

* Srinivasan R, Mehta AA. Torticollis: A comprehensive review for the primary care physician. *J Am Osteopath Assoc*. 2018;118(11):748-756. PMID: 30455178

* Lee J, Sung I, Chun S, Cho Y, Lee S. Congenital Muscular Torticollis: An Update on the Etiology, Pathogenesis, Diagnosis, and Management. *Children (Basel)*. 2021;8(8):642. PMID: 34439055

* Tarsy D, Sheehy MP. Spasmodic torticollis: Recent advances in diagnosis and treatment. *J Clin Neurosci*. 2019;63:1-7. PMID: 30852029

* Kaplan SL, Coryell KJ, International Conference for Consensus on the Management of Congenital Muscular Torticollis (ICCM-CMT) Group. Physical Therapy Management of Congenital Muscular Torticollis: An Evidence-Based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy. *Pediatr Phys Ther*. 2018;30 Suppl 2:S1-S35. PMID: 30001429

* Wiest R, Borg J. Acute Torticollis. *Semin Neurol*. 2015;35(5):548-559. PMID: 26442654

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Q.

Occipital Neuralgia? Why Your Nerves Flare & Medically Approved Next Steps

A.

Occipital neuralgia is irritation of the occipital nerves in the upper neck that causes sharp, electric pain from the base of the skull to the scalp or behind the eyes, most often tied to neck muscle tension and posture, but sometimes to injury, arthritis, disc disease, diabetes, or rarely structural problems. There are several factors to consider; diagnosis is clinical and can be supported if a nerve block eases the pain, and medically approved next steps progress from heat, gentle stretching, posture work, physical therapy, and short term OTC pain relievers to prescription nerve pain medicines and nerve blocks, with Botox, radiofrequency, or stimulation for tougher cases and specific red flags needing urgent care. See the complete details below to choose the right next steps.

References:

* Schianchi P, Malagoli M, Lattuca S, Bisi M, Scagnelli C, Baroni M, Galasso M, Baraldi C, Stasi G, Sola F. Occipital Neuralgia: A Review of Diagnosis and Management. Medicina (Kaunas). 2023 Mar 29;59(4):682. doi: 10.3390/medicina59040682. PMID: 37025178; PMCID: PMC10141680.

* Vancampfort S, Van Den Vonder L, Van Raemdonck P, Parizel PM, Van Zundert J. Occipital neuralgia: update on diagnosis and treatment. Curr Opin Neurol. 2022 Aug 1;35(4):444-450. doi: 10.1097/WCO.0000000000001083. PMID: 35928812.

* D'Amico R, Veronesi F, Pignataro A, Malagoli M, Pedrini M, Giacomelli C, Galasso M, Baraldi C. Occipital Neuralgia: A Clinical Review. Medicina (Kaunas). 2022 Aug 23;58(9):1136. doi: 10.3390/medicina58091136. PMID: 36021590; PMCID: PMC9499834.

* Gaul C, Diener HC, Silver N. Occipital Neuralgia: Pathophysiology and Clinical Management. Neurotherapeutics. 2019 Apr;16(2):306-313. doi: 10.1007/s13311-019-00720-3. PMID: 30678255; PMCID: PMC6452286.

* Barmherzig R, Spina A, Al-Khathaami AM, Goadsby PJ. Occipital Neuralgia: Current Concepts in Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2018 Feb 8;22(2):12. doi: 10.1007/s11916-018-0672-0. PMID: 29339304.

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Maxwell J. Nanes, DO

Emergency Medicine

Waukesha Memorial Hospital, Waukesha Wisconsin, USA

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Caroline M. Doan, DO

Internal Medicine

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Benjamin Kummer, MD

Benjamin Kummer, MD

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Icahn School of Medicine at Mount Sinai

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U.S. Department of Veterans Affairs

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References