Occipital neuralgia is a rare neurological condition that involves shooting, shocking, throbbing, burning, or aching pain and headache that generally starts at the base of the head and spreads along the scalp on one or both sides of the head. The condition occurs when the occipital nerves become inflamed or injured. The most common causes of occipital neuralgia include:

• Pinched nerves or muscle tightness in the neck
• Head or neck injury
• Nerve compression
• Disc disease
• Infection and inflammation

In some cases, "tight" muscles at the back of the head can entrap the nerves. However, in many cases, doctors cannot find one specific cause.

Diagnosis of occipital neuralgia is usually done through a physical and neurological exam, along with diagnostic imaging. A nerve block (in which a local anesthetic and steroid drug are injected into the area around the nerve) may help with diagnosis. Relief with a nerve block may help to confirm the diagnosis. For patients who do well with this temporary "deadening" of the nerve, a more permanent procedure may be a good option.

Treatment options for occipital neuralgia include medications, steroid injections, heat, and surgery. Nonsurgical treatment may include hot therapy, massage therapy, nerve blocks, physical therapy, and botulinum toxin (Botox®) injections to decrease inflammation. If you or a loved one has occipital neuralgia, consider participating in a clinical trial so clinicians and scientists can learn more about the condition and head and neck pain.