How To Treat Occipital Neuralgia

Occipital neuralgia is literally a pain in the neck. Starting at the top of the spinal cord and traveling up the back of the head, the occipital nerves can be a source of serious head and neck pain from injury or inflammation. Right now, the underlying cause of occipital neuralgia has not completely been determined. Unfortunately, occipital neuralgia can flare up doing almost anything, and simply brushing hair, lying down on a pillow, or even touching the neck can bring on intense pain. Individuals may feel a stabbing, zapping electrical jolt in their neck or head lasting anywhere from a second or two to several minutes. How can occipital neuralgia be treated? Find out now.

Apply Hot Compress To Neck

Applying a hot compress to the neck is a fast and easy way to get some relief during an occipital neuralgia flare-up. A warm, lightly damp washcloth is the classic hot compress choice. Using a microwave or a bathroom sink, heat a washcloth with water. Placing the heated washcloth in a plastic bag will not just prevent drips, but will help keep the heat in longer. Other types of hot compresses are also effective. Some reusable compresses include microwaveable pads or cloth tubes filled with uncooked rice or beans. A heating pad or warm water bottle can also help provide soothing comfort.

Applying a hot compress safely requires individuals to place it on or across their neck or forehead, taking it off every twenty minutes or so. Individuals should also lie down in a quiet, dark room where the compress can remain in place without shifting too much. If the compress is very hot, individuals should put a fabric barrier like a t-shirt or light towel between the compress and their skin to prevent burns or redness. The warmth will increase blood flow to the site and help to relax the tightened muscles in the neck and head. The relaxation will help ease pain.

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Take Pain Medication

When experiencing occipital neuralgia, it’s worth starting with trying over-the-counter pain solutions such as ibuprofen or acetaminophen. For severe flare-ups, however, patients may wish to take prescription pain medication. Thus, they must consult with a physician for the best course of treatment. Doctors may start with medications intended to reduce inflammation and relax muscles, though they may recommend stronger medications for severe occipital neuralgia. These stronger choices include antidepressants or medications to prevent seizures in epilepsy. More serious steps to control occipital neuralgia include getting an occipital nerve block. In this procedure, the doctor will inject a local anesthetic along the occipital nerve. The nerve block can last for up to twelve weeks, and the procedure can be repeated as necessary.

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Massage Neck Muscles

Massaging neck muscles is a classic approach to self-care and pain management. A sports massage or professional provider can help, particularly if patients have impaired mobility in the arms or shoulders. However, many individuals can massage their neck muscles and surrounding areas without assistance. First, individuals should warm their hands under water. They may also wish to soften their hands with a non-irritating oil or lotion. Patients can start by gently squeezing each side of their neck with their whole hand, moving gradually down from their head to their shoulders. Patients can rub the muscles of their right and left shoulders in small circles with their fingers and apply appropriate pressure where they feel tightness or tension. They should gently use the tips of their fingers to rub where their head joins their neck. For hard-to-reach areas in the middle of the back, individuals can place a tennis ball or golf ball in the middle of a sock and draw it back and forth over the tense muscle. Additionally, they can lie down on the ball and roll it to the affected area for more pressure.

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Occipital Nerve Stimulation

Occipital nerve stimulation is a more medicalized approach to treating occipital nerve pain. Physicians sometimes recommend this procedure in cases where other methods of pain management have not worked. During the occipital nerve stimulation procedure, an electrode is placed below the skin in the area affected by occipital neuralgia. A pulse generator is also placed below the skin in the collarbone, buttocks, back, or abdomen. The pulse generator sends an electromagnetic signal to the occipital nerve to relieve pain. The patient is given a remote control device they can operate as needed. With the device, they can send a pulse to the occipital nerve during an attack, and because the lead lines are placed beneath the skin and outside the skull, there is no risk of damaging their spine or triggering a stroke. This method may not work for all patients. However, it has been helpful to many for whom pain medication, including a nerve block, has not been effective.

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Microvascular Decompression

Microvascular decompression is a complex surgical procedure with the purpose of alleviating compression of the occipital nerve, which is one possible cause of occipital neuralgia. In this operation, a surgeon opens the patient’s skull at the back of the neck. The nerve is separated away from the blood vessel, connective tissue, or muscle that may be constricting or compressing the nerve. In some cases, the surgeon may place a tiny sponge between the occipital nerve and the blood vessel. This sponge essentially cushions the occipital nerve from the compression that triggers pain. Although this is a serious surgery and may not be possible for all patients, microvascular decompression works to significantly alleviate occipital nerve pain in most cases.

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Pulsed Radiofrequency

Pulsed radiofrequency treatment is a treatment used for multiple chronic pain syndromes, including recurrent occipital neuralgia. This is considered a non-ablative treatment that can be used as an alternative to continuous radiofrequency ablation. Instead of using continuous radiofrequency currents, pulsed radiofrequency therapy uses short current burst, and there's not enough heat to cause tissue coagulation. The treatment leads to an interruption of the pain signals the nerves send, keeping them from reaching the brain. However, unlike continuous radiofrequency treatment, this therapy doesn't cause permanent damage to the nerve fibers because the temperature doesn't rise higher than forty-two degrees Celsius. By comparison, continuous therapy can cause the fibers to reach temperatures of eighty degrees Celsius.

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Nerve-Blocking Injections

Occipital neuralgia can sometimes be treated through nerve-blocking injections, which block certain nerves from sending pain signals. Nerve blocks. Many practitioners will use an imaging tool to make sure they target the correct area. Common imaging tools include CT scans, ultrasounds, or fluoroscopes. The needle injects pain-relieving medication around the nerves causing the occipital neuralgia, which numbs the overall area. There are multiple types of nerve blocks, some which act on a temporary basis and others that have longer-lasting effects. In a peripheral nerve blockade, the doctor will inject medicine around the peripheral nerves that cause pain. Nerve blocks cause immediate pain relief, and they may also provide longer-lasting relief by allowing the nerves to heal.

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Muscle Relaxants

Muscle relaxants are a conservative treatment method that can be applied at home. Muscle relaxing medications help treat muscle spasticity and reduce muscle tension, which can help relieve symptoms of occipital neuralgia. There are some prescription-strength muscle relaxants patients can use if over-the-counter medications don't work. OTC medications include nonsteroidal anti-inflammatories, which keep the body from creating inflammation-causing substances. Acetaminophen blocks the body from making pain-causing substances. These are the main pain medications used for at-home treatment of occipital neuralgia. On a prescription basis, antispasmodics can be prescribed to relieve muscle spasming through the central nervous system. However, patients shouldn't use these medications for more than two or three weeks.

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Rest In A Quiet Room

Occipital neuralgia is often caused by pinching or injury to the occipital nerves. The condition can also be related to infection, inflammation, arthritis, or tumors. None of these things can be fully treated through rest alone, though pinching does tend to heal itself over time. However, loudness and bright lights can sometimes exacerbate headache symptoms. If an individual is dealing with a lot of sensory stimuli at once, it can cause their head to pound. When added to already-existing occipital neuralgia, this kind of headache can seem unbearable. One way to address this is through rest in a quiet room. They should also turn off the lights, block out the noise, close their eyes, and relax their muscles as much as possible.

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Anticonvulsants

Anticonvulsants may be prescribed if at-home treatments and remedies don't work. These might be prescribed in conjunction with other pain-relieving or muscle-relaxing medications. There are multiple kinds of anticonvulsant medications that function in different ways, and some may be more helpful than others for occipital neuralgia. One potential way the medications work is by altering the electrical activity in the neurons and cells through changing the ion channels, which can help relieve nerve pain in the occipital nerves. Other anticonvulsant medications affect neurotransmitters in the brain. These may not be so helpful for this kind of pain because they don't affect the nerves directly.