What is Cervical Neuralgia?

Cervical neuralgia, also known as occipital neuralgia, is a type of neuralgia that can affect the greater occipital nerves. These nerves typically emerge from the spinal column at the back of the neck, and can extend through the muscles of the scalp as far forward as the forehead. Cervical neuralgia can cause tingling, throbbing, or stabbing pain on the back of the head and in the upper neck, or on the entire scalp and forehead. Sometimes, pain is accompanied by swelling and tenderness, and the pain is often, but not always, confined to one side of the head. Treatment can include nerve blocks, antidepressants, anti-inflammatory drugs, heat, rest, and massage.

Though often very painful, occipital neuralgia is not considered to be life threatening. It can occur without obvious cause, as the result of a scalp injury, or as a complication of scalp surgery. Cervical neuralgia can also occur when one or both of the occipital nerves becomes pinched or entrapped, either by spinal problems or muscle tension. Tumors or lesions in the neck, gout, diabetes, and vasculitis are sometimes implicated in the development of this type of neuralgia. Tilting the head forward for long periods of time can also contribute to this condition.

Cervical neuralgia typically causes piercing headaches that most often begin on the back of the head or in the upper neck. Neuralgia headaches often begin in the neck and spread towards the front of the head. Pain can occur behind the ears, behind the eyes, and on the scalp and forehead. The scalp and forehead can become inflamed and pain can be severe enough that any physical contact with the area can be unbearable for the patient.

An occipital nerve block can be used to numb sensation in the occipital nerves, relieving the pain of cervical neuralgia. Occipital nerve blocks are generally administered as a diagnostic procedure, and patients who respond well to them may be candidates for more invasive, more permanent procedures, if necessary. Surgery often focuses on permanently numbing the occipital nerves, which can relieve the pain of the condition, but often leaves the scalp, forehead, and neck feeling somewhat numb on a permanent basis. Compression of the occipital nerve can often be relieved by surgical removal of the bone, muscle, or other tissue responsible for the compression. An occipital nerve stimulator can be installed to relieve pain by stimulating the occipital nerve with electric shocks, though this procedure often leads to permanent tingling sensations in the scalp, forehead, and upper neck.

In many cases, more conservative treatments can manage the symptoms of cervical neuralgia until the occipital nerve can heal naturally. Anti-inflammatory and antidepressant drugs might be prescribed. Massage, heat, and rest can help relieve the muscle tension that often leads to trapped nerves.