Occipital Neuralgia: Typical Cause of Chronic Headaches and Migraines

Diagnosis of Occipital Neuralgia

Headaches and migraines causes by the occipital nerves are usually easily diagnosed.  Simply compress the area over the occipital ridge and roll the finger across the region. If compression of this area recreates, intensities or creates a sudden headache then it’s typical that occipital neuralgia is the diagnosis and cause of patients pain.

Causes

Headache caused by the occipital nerves generally are caused by chronic or sudden compression of the nerves as they start become superficial (just underneath the skin) in the upper neck and skull.  There are both chronic and sudden (acute) causes or mechanisms.

Chronic

Sustained  shortening of the subocciptal muscles over long periods of time is a common mechanism of headaches.  The brains objective is to keep the eyes on the horizon for proper vision. When poor posture puts the head in front of the thorax relative to gravity the upper neck needs to extend to keep the eyes looking forward. When is occurs such as when working on a computer, The upper neck  is compressed and and creates compression on the occipital nerves and then creates neuraglia symptoms.

Acute

  • Quick stretch and injury occur during a whiplash injury common in car accidents
  • Muscle and fascial stiffness in the upper neck. In chronic cases nerve entrapment occurs
Picture of painful greater occipital nerve

Treatment

  • Neurodynamically stretching the greater and lesser occipital nerves. Typical aggressive muscle stretching will most likely make it worse.
  • Postural correction exercises and ergonomic modifications
  • Fascial release of surrounding connective tissues around the nerve.

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