Occipital neuralgia is not easy to diagnose due to its similarities with specific headache disorders, such as migraine. If you suddenly experience sharp pain in your scalp or neck, then you should book an appointment to see an Experienced Pain Specialist as soon as possible. As general doctors do not have the additional training & expertise in this field, then you will stand the best chance of receiving a correct diagnosis, & ameliorating you condition in the shortest possible time
Occipital neuralgia describes people who have a long-term precise type of headache, which is accompanied by electric-shock-like, throbbing or piercing pain, behind the ears, at the back of the head (normally on one side), and in the upper neck. The pain emanates from the neck, and then moves in an upward direction. A percentage of people will also feel pain behind their ears, on their forehead, and in their scalp, which could be tender if touched. In addition, their eyes may be particularly sensitive to light .
The pain location is linked to the regions which are serviced by the lesser and greater occipital nerves. – These begin in the region where the spinal column adjoins the neck, up to the back of the head (scalp). Injury and/or irritation to the nerves, are usually the reason for the pain that you may be feeling. In some instances, the Pain Consultant will find that this is down to ultra-tight neck muscles which have generated nerve impingement (pinched nerves), from trauma to the back of the head. This is often down to scoliosis of the cervical spine, tumours or other lesions within the neck region, or osteoarthritis .
“Localized inflammation or infection, gout, diabetes, blood vessel inflammation (vasculitis), & frequent lengthy periods of keeping the head in a downward & forward position are also associated with occipital neuralgia. In many cases, however, no cause can be found. Relief from pain after an anaesthetic nerve block [which can be administered by a Pain Specialist], will confirm the diagnosis” .
So What Symptoms Should I Look Out For?
Feeling pain at:
• one side of the head
• the back of the head
• the top of the neck
• behind the ears
• behind the eye (on the affected side)
• the scalp, (particularly where the occipital nerves link up)
• behind the eye (on the affected side of the head) 
You may also experience:
• light sensitivity
• sensitivity and soreness when touched
• intermittent bursts of pain which can last a few minutes/seconds
• a lingering ache between heavier pain episodes .
. NIH (2022). “Occipital Neuralgia Information Page.”
. Hammond, N. (2020). “What you need to know about occipital neuralgia.”