Can A Chiropractor Help Occipital Neuralgia?

June 1, 2020Dr. Grant Radermacher

When it feels like a headache – but isn’t!

At Ascent Chiropractic, it’s often the case with rare conditions that when it rains, it pours. We see new patients with back pain, neck pain, tension and migraine headaches, shoulder pain and knee and ankle injuries walk into our office literally every day. But then we’ll get a sudden surge of some relatively uncommon condition. Recently it’s been problems stemming from the occiput – the bottom part of the skull that connects to your spine and through which your spinal cord exits.

Specifically, we’re going to talk about an extremely painful condition known as occipital neuralgia. Patients usually describe it as a sharp, stabbing pain in the back of their head – “ice pick headache” is a classic description.

Occipital neuralgia can sometimes also be experienced as:

• Electricity: Shock-like, piercing and white-hot pain associated with electricity in the back of your skull.
• A Tender, Aching Scalp: Burning, throbbing or numbness from the base of your head up to your scalp.
• Severe Neck Pain: Sharp, intense pain when moving your neck.
• Radiating Pain: The pain experienced can be felt up through the top of your head, even toward your eyes.
• Light Hypersensitivity: Bright fluorescent lights and changes in light levels can exacerbate occipital neuralgia pain.

The pain usually occurs on and off and can last anywhere from a few minutes to hours at a time.

Migraines or Occipital Neuralgia?

Occipital neuralgia is often misdiagnosed by doctors as classic migraines. In fact, new research suggests that anyone who suffers from migraines (especially those that respond poorly to migraine medication) should be screened for occipital neuralgia, as the symptoms are so similar.

But even though they seem similar, occipital neuralgia has a completely different mechanism of action.

Occipital neuralgia is a condition that affects the greater occipital nerves – a set of nerves that exit your spinal column between the C2 and C3 vertebrae in your neck and supply the back and top of your head with innervation. When the joints between your occiput and upper cervical vertebra aren’t working correctly, the resulting localized inflammation can irritate these sensitive nerve fibers, causing them to fire.

This dysfunction in the movement of the vertebral joints can be a result of an injury or developmental structural abnormality, but it also frequently shows up totally out of the blue, without explanation.

Treatment of Occipital Neuralgia

Whatever the reason, treatment is aimed at reducing the inflammation surrounding these nerves.

The first line of traditional medical treatment is usually oral anti-inflammatory medication, muscle relaxants or in some cases anticonvulsant medication. If that doesn’t work, it’s often followed by cortisone-injection nerve blocks and/or nerve ablation, which effectively burns the affected occipital nerve to prevent it from continuing to fire.

However, those approaches do nothing to address the root cause of the inflammation, and they usually only provide temporary relief at best. At Ascent Chiropractic, we use a unique adjustment technique called an occipital lift, along with manual traction and active strengthening exercises, to correct the joint dysfunction in the upper cervical spine causing the inflammation that leads to occipital neuralgia.

In most cases, patients stand a much better chance of staying pain-free taking this treatment route.

One of the patients I had mentioned above, a 27-year old male, was taking a prescription NSAID twice a day, every day – indefinitely – to keep his occipital neuralgia pain at bay. He’d been taking it for 4 years, and if he missed even one dose the pain would return. Within two weeks of treatment at Ascent, he was completely off his medication and the occipital neuralgia pain hasn’t returned.

Another 72-year old patient with occipital neuralgia was literally hospitalized because the pain was so unbearable before she reached out to us. But again, a few treatments later her pain was gone. Now we keep it in check with regular monthly chiropractic maintenance care treatments.

The Ascent Chiropractic Difference

At Ascent Chiropractic – your Brookfield chiropractor – we’re committed to not just relieving pain but to correcting it’s cause and optimizing your body to function better than it ever has before.

Our unique, low-force, evidence-based approach to treatment allows us to correct spinal biomechanics, restore normal joint function, and get you out of pain and on the road back to optimal health.

Don’t want pain to be part of your future? Schedule an appointment by calling us at 262-345-4166 or use our online scheduling app.

Source: Comley, L. Chiropractic management of greater occipital neuralgia. Clinical Chiropractic. 2003;6(3-4):120-128.

Sahai-Srivastava S, Zheng L. Occipital neuralgia with and without migraine: difference in pain characteristics and risk factors. Headache. 2011;51(1):124‐128.