Occipital Neuralgial Headaches
The International Headache Society (IHS) defines occipital neuralgia as:
A paroxysmal jabbing pain in the distribution of the greater or lesser occipital nerves or of the third occipital nerve (nerves running up the back of the neck and head), sometimes accompanied by diminished sensation or dysaesthesia (abnormal sensation) in the affected area. It is commonly associated with tenderness over the nerve concerned.
Accordingly, the IHS specifically describes occipital neuralgia as a condition in which “pain is eased temporarily by the local anesthetic block of the nerve”. This supports the notion that the symptoms are primarily due to a “nerve trigger point” problem, as local anesthesia works on nerves to temporarily deaden them.
Occipital neuralgia causes similar problems to migraine headaches, but may respond very differently to certain forms of treatment. Both conditions can be initially treated with medication, yet many of our patients observe better lasting results with Botox® injections. Those who receive successful results from Botox® treatments may continue with a surgical procedure as an intended permanent way of reducing or eliminating their pain.
Many of our occipital neuralgia patients report the onset of the condition following a traumatic event, such as a car accident or fall. A whiplash injury that causes inflammation in the head and neck region may result in the occipital nerves becoming sites of these “trigger points”. Patients with this type of history tend to respond the best to injection therapy or even to trigger point decompression surgery.
Conversely, in patients with confirmed occipital neuralgia, we rarely see a patient who does not report some improvement from Botox®. The reason behind this may be connected to the fact that occipital neuralgia is a condition that is primarily due to “nerve trigger points” as opposed to migraines, in which the underlying problem may be due to a combination of factors.
Both occipital neuralgia and migraine headaches are initially treated with medication in an attempt to reduce symptoms and prevent or alleviate the occurrence of headaches. Although medical therapy can be very effective, for many headache sufferers medication can be less effective over time. If the side effects of the medical therapy outweigh the benefits, the individual may discontinue taking the medications, forced to deal with the consequences.