Symptoms of occipital neuralgia are similar to those of tension type headaches and migraine and are therefore often misdiagnosed. However, a correct diagnosis is needed to find effective treatment. To accurately diagnose occipital neuralgia, physicians will conduct a thorough history and physical exam. Once this condition is suspected, an occipital nerve block can be performed. If pain relief is reported from the nerve block, a diagnosis of occipital neuralgia is confirmed.
In order to determine the cause of occipital neuralgia, a detailed history and physical exam will be performed. Questions relating to vision changes, dizziness, as well as nausea or vomiting will help to determine if there is impingement of the cranial or cervical nerves. In addition, doctors perform various assessment tests including percussion of the nervus occipital major and minor in an attempt to elicit tenderness.
Physicians may also order special imaging procedures such as X-rays, computer tomography (CT), or magnetic resonance imaging (MRI) to rule out any underlying pathology.
After a diagnosis of occipital neuralgia is confirmed, a comprehensive pain management treatment plan will be developed to help manage your symptoms. Home remedies for occipital neuralgia that is fairly mild may include:
Hot or cold therapy for the neck
If your occipital neuralgia pain doesn’t respond to these at-home remedies, you can try some complementary therapies. A number of these conservative treatment options exist, and do help patients reduce pain. They include:
These treatment options are usually recommended as a first line treatment, after at-home remedies, because they are non-invasive and provide pain relief in many cases. They also have few side effects and can be used in conjunction with other therapies or medications. Chiropractic care, physical therapy, and massage are all designed to reduce stress and tension in the body, which can then reduce tension along the occipital nerve.
Likewise, acupuncture for occipital neuralgia is suggested to release endorphins into the body, that can then reduce pain and improve overall quality of life.
Complementary therapies are an important part of any chronic pain management plan. When talking to a doctor, ask how you can use these therapies along with any more advanced therapies they recommend. While chiropractic or other therapies won’t cure occipital neuralgia pain, they can reduce overall pain, the amount of days you experience pain, and improve other aspects of your life.
Chiropractic for Occipital Neuralgia | PainDoctor.com
Medications for occipital neuralgia
Traditional pharmacological management for this condition involves the use of:
Non-steroidal anti-inflammatory medications
However, for true cases of occipital nerve pain, many patients won’t find much relief through traditional medications. Instead, interventional treatments can be one of the best occipital neuralgia treatments, especially for those who suffer from moderate to severe pain.
Interventional occipital neuralgia treatments
If patients do not respond to conservative measures and pharmacological management, there are additional therapies that can be offered which are relatively non-invasive. These occipital neuralgia treatments include:
Occipital nerve blocks
Botulinum toxin (Botox) injections
Occipital nerve blocks entail injecting a local anesthetic in combination with a steroid into the area of the occipital nerve. The injection helps to block pain sensation of the occipital nerve. Patients receiving occipital nerve blocks usually report significant pain reduction. Research has shown that occipital nerve blocks are a safe and effective diagnostic and therapeutic option for patients suffering from occipital neuralgia.
Injections using Botox are another option that may be offered to patients who suffer from occipital nerve pain. They involve injecting botulinum neurotoxins into the tissue, which help to block nerve impulses that are overactive. It has been suggested that the Botox toxin influences the pain sensory system by interfering with neurotransmitter release. A study published in Current Pain and Headache Reports found that patients had significant reductions in headache pain for the four-week period following treatment with Botox injections.
If all other treatment options fail, radiofrequency ablation may be recommended. Radiofrequency ablation involves inserting a probe through the skin to deliver a high-frequency electrical current to disrupt nerve conduction. In a prospective trial published in Pain Practice, more than 68% of patients suffering from occipital neuralgia reported decreased pain within one month of having radiofrequency ablation. While this study was small, having only 19 participants, it suggests that treatment using radiofrequency ablation may prove to be an effective treatment option for individuals who do not respond to conservative treatment methods.
Occipital Neuralgia Treatments | PainDoctor.com
Surgery for occipital neuralgia
In rare cases, your doctor may suggest surgery for your pain. Surgery should only be done when all other, less invasive options have been tried. If your pain hasn’t responded to other treatments, your doctor may suggest:
Occipital nerve stimulation
Again, while surgery may be the best option for some patients, make sure you’ve exhausted other options before undergoing surgery. If you haven’t attempted interventional treatments coordinated with complementary therapies, talk to your doctor about what options you may have.
If occipital neuralgia is the suspected cause of your headache pain, your physician will conduct a history and physical exam and then perform an occipital nerve block to confirm your diagnosis. Once the cause of your occipital neuralgia pain is determined, your doctor will work with you to find an appropriate treatment to help you manage your symptoms. Although this condition can be extremely painful, it can be successfully treated with home remedies, complementary therapies like chiropractic care, or interventional treatments like occipital nerve blocks.
Global Neuro & Spine Institute physicians are double and triple-board certified, fellowship trained, and remain on the cutting edge of technology. In our practice, we use the most advanced techniques and the highest standards to develop an individualized and comprehensive treatment plan for each of our patients. We are also very proud of our policy to place great importance on educating those we treat, while addressing any questions or concerns that may exist.
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