Providing high quality and thorough chiropractic care to people of all ages.
Occipital neuralgia can be quite debilitating, however, it is important to know that there are very effective ways to manage this condition – including Chiropractic Care. Understanding occipital neuralgia can assist you in better managing this condition so that you can work towards alleviating the pain and discomfort that you may be experiencing.
Occipital neuralgia is a neurological condition that affects the set of nerves in the back part of your head, called the ‘greater occipital nerves’. These nerves exit your spinal column from the top portion of your spinal cord, pierce through the muscles at the back of your neck and then run through the back of your scalp extending to above your forehead.
Occipital neuralgia occurs when the greater occipital nerves are injured or become inflamed due to pressure or irritation.
The localised inflammation of the greater occipital nerves most commonly occurs due to compression from tight muscles in the neck – commonly tightness of the upper trapezius, or when there are dysfunctions between joints around your upper cervical spine and skull – occiput.
From a postural perspective, prolonged forward head carriage as a result of poor posture can contribute to the development of tight neck muscles, as well as spinal dysfunctions. In addition, ‘spinal dysfunctions’ may also be present due to a developmental structural abnormality, after an injury – such as whiplash, or may occur as a compensatory biomechanical change in response to physical, chemical and/or emotional stresses.
Other medical conditions that have been linked to occipital neuralgia include diabetes, gout, infection, osteoarthritis and less commonly, cervical disc disease and neck tumours.
The presentation of occipital neuralgia is quite distinctive. The irritation of the sensitive nerve fibres of the greater occipital nerves often presents as a pain on one side of the head that typically begins between the top part of the neck and the base of the skull, and radiates upwards to the back of the scalp behind the ears. At times, the pain may be felt behind the eye on the affected side as well. This pain that is commonly associated with occipital neuralgia is described as an intense, sharp, burning, throbbing and electric-shock-like pain that shoots up the back of the scalp, before settling to a tender aching sensation and sometimes numbness in the affected area. Although this pain comes and goes randomly, it is often triggered by neck movement and can last from a few minutes to even a few hours.
Occipital neuralgia is also associated with scalp tenderness – where the scalp becomes extremely sensitive to even the lightest touch – which may make brushing your hair, washing your hair, or laying on a pillow painful. Additionally, the resulting muscle spasms in your neck can reduce your ability to flex or rotate your neck.
Given the fact that there is no unique test to diagnose occipital neuralgia, the diagnosis of this condition is made after taking into consideration a patient’s history – including signs and symptoms – as well as conducting a physical examination – to identify localised inflammation of the greater occipital nerve and identify the cause of the irritation.
As with many other conditions with a musculoskeletal origin, it seems that it is always possible to ‘push through’ the symptoms until the symptoms temporarily subside. However, by not addressing the problem from its root, there can be consequential effects on the function of your skeletal system, nervous system, muscular system as well as your soft tissues. As a result, your ability to move, feel and function at your best can be lost.
The medical approach to helping with occipital neuralgia may initially involve oral anti-inflammatory medication, muscle relaxants or in some cases, anticonvulsant medication. For more persistent cases, cortisone-injection nerve blocks and/or nerve ablations may be utilised to essentially ‘kill’ the affected nerves. However, these approaches merely focus on covering up the symptoms without addressing the root cause of the irritation and inflammation.
Chiropractic Care involves providing relief from occipital neuralgia by reducing the inflammation and irritation of the greater occipital nerve by addressing the root of the problem as opposed to solely managing the pain. This is achieved using specific spinal adjustments, traction, active strengthening exercises, heat and soft tissue therapy. Essentially, these techniques effectively restore proper alignment which allows for optimal functioning of the musculoskeletal and nervous system. The advantage of Chiropractic Care over other methods is that it does not come with the adverse effects associated with medications nor with the risks of surgery.
In cases where the pain associated with occipital neuralgia is severe, chronic and unresponsive to conservative methods, we may refer you to see another healthcare professional.
Article written by Dymal Champaneri (Chiropractor)