Diagnosing Occipital Neuralgia

Diagnosing Occipital Neuralgia

The greater and lesser occipital nerves are located at the back of a person’s head, namely in the area where the neck and the spinal column meet right up to the scalp at the back of the head.

If these nerves are damaged or injured, or even simply irritated, then a sensation of pain is felt as a headache, that starts usually at the lower part of the neck and then ‘travels up’ to one side of the head and the forehead and the scalp may be painful and the scalp can often be intolerant of any touch, so even a finger gently placed on the scalp will not be tolerated. The pain is usually described as throbbing or stabbing and similar to migraines, the pain can often result in nausea, especially when there are very short bursts of pain. Light sensitivity is also possible.

Very often there is a feeling that there is some kind of pain or pressure affecting the area behind the eyes and this can be quite distressing for patients.

Difficulty in Diagnosis

The condition of occipital neuralgia is not one that may be readily apparent if there has been no injury or trauma to the occipital nerve and there is sometimes uncertainty as to whether the headache (usually headaches) are severe tension headaches, migraine headaches or the neuralgic condition occipital neuralgia.

Usually people with occipital neuralgia will have some difficulty in moving their neck from side to side or rotating it, but this is not always the case.

Help Your Pain Consultant

A history of the headaches can greatly help an accurate diagnosis to be made. This history should be compiled as soon after the headache has eased as is possible. A note should be made of when the pain started, where it ‘travelled to’ within the head and other symptoms that were experienced, such as nausea, light sensitivity, pressure felt behind the eyes etc.

This helps actually paint a picture of what happened and present really valuable data to ensure a speedy diagnosis. It is also much more detailed than describing a ‘terrible headache that rendered me helpless’, since this could be migraine, it could be a very extreme tension headache but could also be occipital neuralgia.

Once the diagnosis has been made, then an effective course of treatment can be initiated. It may also be helpful to keep a diary of any headaches after the treatment has begun and to ‘score’ them in terms of pain, with 1 being a fairly minor headache and 10 being pain that is almost unbearable. This will ensure that when you next visit your pain consultant, you have an accurate record of the pain that you have experienced and can refer back to the diary. Otherwise you are relying on memory, and there are times when you can simply ‘forget’ to include details that would actually have helped to illustrate exactly what you felt, but a diary ensures that all details are right there in front of you.

This will help inform and guide your pain consultant, so that working together you can ensure that the treatment you receive is the most effective possible.