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Occipital Neuralgia - Overview & Conservative Treatments

As an occasional sufferer of occipital neuralgia, I can speak intimately on how this condition presents, and what treatments have been effective for me in managing attacks. Being a chiropractor in our Beaverton clinic, I favor non-pharmacological therapies, including self-myofascial release, acupuncture, and chiropractic manipulation. 

Occipital neuralgia is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. Wrapped around the greater occipital nerve is the occipital artery, which can contribute to the neuralgia. The condition is also sometimes characterized by diminished sensation in the affected area.

The main symptom of occipital neuralgia is chronic headache. The pain is commonly localized in the back and around or over the top of the head, sometimes up to the eyebrow or behind the eye. Because chronic headaches are a common symptom of numerous conditions, occipital neuralgia is often misdiagnosed at first, most commonly as tension headaches or migraines, leading to unsuccessful treatment attempts. Another symptom is sensitivity to light, especially when headaches occur.

Occipital neuralgia is characterized by severe pain that begins in the upper neck and back of the head. This pain is typically one-sided, although it can be on both sides if both occipital nerves have been affected. Additionally, the pain may radiate forward toward the eye as it follows the path of the occipital nerve(s). Individuals may notice blurred vision as the pain radiates near or behind the eye. The pain is commonly described as sharp, shooting, zapping, an electric shock, or stabbing. The bouts of pain are rarely consistent, but can occur frequently depending on the damage to the nerves. The amount of time the pain lasts typically varies each time the symptom appears; it may last a few seconds or be almost continuous. Occipital neuralgia can last for hours or for several days.

Other symptoms of occipital neuralgia may include:

  • Aching, burning, and throbbing pain that typically starts at the base of the head and radiates to the scalp
  • Pain on one or both sides of the head
  • Pain behind the eye
  • Sensitivity to light
  • Sensitivity to sound
  • Slurred speech
  • Pain when moving the neck
  • Difficulty with balance and coordination
  • Tender scalp
  • Nausea and/or vomiting

Conservative Treatment

Due to the relatively accessible location of the occipital nerve and surrounding muscles and fascia, non-invasive therapy is easy to apply and quite effective. At Back In Motion Chiropractic & Sports Rehab in Beaverton, our traditional treatment for this occipital neuralgia includes both cervical joint manipulation and myofascial release. A typical therpay session will include Active Release Technique of the suboccipital muscles, instrument assisted soft-tissue release (Graston Therapy) of the suboccipital and occipital fascia, electrical stimulation of the cervical musculature, and finally cervical joint manipulation - the chiropractic adjustment. For home care, I really love using a lacrosse ball to release the occipital fascia:


It's important to act quickly when you feel symptoms coming on for either a tension headache or occipital neuralgia flare up. Apply ice to the upper neck, practice the lacrosse ball release technique shown in the video, and call Back In Motion to schedule your appointment for myofascial release and joint manipulation. While symptoms may resolve on their own in time, I can tell you from experience that hitting this head on with both treatment from a professional and self care will get you feeling better much more quickly, so don't hesitate.

Back In Motion Chiropractic & Sports Rehab - Proudly Serving the Beaverton and Portland Community for 30 Years - "Moving Toward Your Finish Line"






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