Occipital neuralgia, also known as pain in the back of the head, is a common cause of headaches. Pain in the back of the head involves the occipital nerves. These nerves are two pairs of nerves located close to the second and third vertebrae of the neck. Throbbing at the back of the head, usually begins at the nape along with the base of the skull, can spread to the area behind the eyes and the back, front, and side of the head.
Why is There Pain in the Back of the Head?
Pain in the back of the head is a headache syndrome that can be primary or secondary. Secondary headaches are associated with an underlying disease that may include a tumor, trauma, infection, systemic disease, or bleeding. While any of the following is the cause of throbbing in the back of the head, many cases can be attributed to chronic neck tension or unknown origins. Causes of pain in the back of the head in general include;
- Osteoarthritis of the upper cervical spine,
- Trauma to larger and/or smaller occipital nerves,
- Compression of larger and /or smaller occipital nerves or C2 and/or C3 nerve roots from degenerative cervical spine changes,
- Cervical disc disease,
- Tumors affecting C2 and C3 nerve roots,
- Blood vessel inflammation and infection.
What are the Symptoms of Occipital Neuralgia?
Symptoms of occipital neuralgia include persistent pain, burning, and throbbing, also known as intermittent, shocking, or shooting pain. Throbbing in the back of the head is often described as a migraine-like problem. Some patients experience other symptoms common to migraines and cluster headaches. The pain usually occurs at the base of the skull and spreads to the back or side of the scalp. Some patients feel pain behind the eye on the affected side. Pain is most often felt on one side of the head, but can also affect both sides of the head. Neck movements can trigger pain in some patients. The scalp can be sensitive to touch, and an activity such as combing the hair can increase a person’s pain. In addition, this problem can also manifest itself as pain and throbbing behind the ear.
How is Occipital Neuralgia Diagnosed?
Distinguishing occipital neuralgia from other types of head pain can be quite difficult. Therefore, diagnosis or diagnosis requires scope. It will include a comprehensive assessment, medical history, physical examination, and diagnostic tests. A doctor can document symptoms and determine the extent to which these symptoms will affect the daily life of the patient. If there are abnormal signs of neurological examination, the doctor may order the following tests;
- Magnetic resonance imaging (MRI): a diagnostic test that introduces images of three-dimensional body structures using powerful magnets and computer technology. It can show direct evidence of spinal cord obstruction caused by bone, disc, or hematoma.
- Computed tomography scan (CT or CAT scan): a diagnostic image created after a computer sails x-rays; it can show the shape and size of the spinal canal, its contents, and structures around it.
How Does the Pain in the Back of the Head Go?
The question of how the pain in the back of the head passes is very important for people who experience this problem. Pain in the back of the head will create problems with each passing time. For this, it is necessary to be treated in a short time. The purpose of treating occipital neuralgia is to relieve pain as much as possible. Pain relief analgesics, including anti-inflammatory and novelistic drugs, can be used to massage the back of the head in the first place. Along with the heat, rest, or physical therapy, the problematic symptoms heal and soon disappear. Oral anticonvulsant drugs such as carbamazepine and gabapentin can also help relieve pain. Percutaneous nerve blocks not only help in the diagnosis of occipital neuralgia but can also help relieve pain. Nerve blocks include the occipital nerves or, in some patients, the C2 or C3 ganglion nerves. It should be noted that steroid use in the treatment of nerve block can cause serious negative effects.
Occipital Neuralgia Surgery
Surgery can be considered when the pain in the back of the head is chronic, severe, and does not respond to conservative treatment. The benefits of surgery should always be carefully weighed against its risks. Microvascular decompression involves microsurgical exposure of the affected nerves, identification of blood vessels that can compress the nerves, and their soft displacement away from the point of compression. Decompression can reduce sensitivity.
It allows the nerves to heal and return to a normal, painless state. The nerves treated may include the C2 nerve root, ganglion, and postganglionic nerve. Occipital nerve stimulation uses a neuro-stimulator to transmit electrical pulses through insulated lead wires tunneled under the skin near the occipital nerves under the head. Electrical impulses can help block pain messages in the brain. The benefit of this procedure is that it is minimally invasive, nerves and other surrounding structures are not permanently damaged.
Warning: At the moment of experiencing symptoms such as pain in the back of the head, throbbing in the back of the head, or pain in the back of the ear, you should see a doctor. All treatments to be applied should be done under the supervision of a doctor.