What is Occipital Nerve?
The sensations felt at the top and back head is transmitted to brain by two greater occipital nerves, one running on each side of head. The nerves emerge amidst the spinal cord in the upper neck regions, making their way through the muscles located behind the head and leading into the scalp. They do not cover the facial regions or the ears.
What is Pinched Occipital Neuralgia?
Irritation in any portion or region of these nerves causes feelings of shooting, electric, zapping, or tingling pain similar to trigeminal neuralgia. But unlike trigeminal neuralgia, in occipital neuralgia, symptoms are present only on one side of the scalp instead of the whole face. Some patients may feel the pain “shooting” or radiating towards one eye. For some patients, their scalp becomes highly sensitive, making the lightest touch, washing hair or sleeping on pillows nearly impossible. Yet other patients may have the affected area numb. In this particular condition, scalp regions where the nerves enter become extremely tender.
Cause of Occipital Neuralgia
A certain pinched nerve root located in neck resulting due to arthritis (for instance) can cause pinched occipital neuralgia. An earlier surgery or injury to the scalp or “tight” muscles behind the head could entrap the nerves causing occipital neuralgia.
Diagnosis and Treatment of Occipital Neuralgia
There are procedures to diagnose occipital neuralgia and it can also be treated temporarily by a procedure called “occipital nerve block” that involves temporal deadening of the occipital nerve. Patients who adjust well and fine with this temporary treatment can also be given a more permanent treatment. There are several permanent treatments including surgical cutting of the nerves, “burning” the nerves with the help of an instrument called radio-wave probe, or removing the affected nerve aided by injection of a minor dose of toxin.
Now, deadening any nerve is bound to have some impacts including deadening or numbing of the part of the body which was fed sensation by that particular nerve, so in this case that area being the scalp. The deadening operation leaves some extent of permanent numbness within that part of the scalp.
Many patients thrive well if their surgery involves sparing the damaged occipital nerve. This can be done if the surgeon can decompress the occipital nerve by eliminating any kind of impinging scar tissue or muscles, or if a pain specialist can insert an occipital nerve stimulator which is a device similar to a pacemaker and helps to stimulate the occipital nerves with electricity that results in tingling feelings instead of pain.
Usually some kinds of medications are administered to “calm down” or make the hyper-active nerves dormant before performing any kind of surgery on them. This is done because all of the above mentioned procedures involve to an extent the risk of permanent consequences or complication. There are patients who take the non-invasive therapy very well.
Prevalence of Occipital Neuralgia
Generally isolated occipital neuralgia is quite rare. Nevertheless, several other kinds of headaches which are specifically migraines can repeatedly or predominantly involving the back of head on one specific side, and inflame the greater occipital nerve passing through the involved side thereby causing confusions in the actual diagnosis of the condition. Doctors usually refer to patients with such peculiar conditions as patients having migraines concerning greater occipital nerve, instead of referring to them as having occipital neuralgia.
