Overview
Occipital neuralgia happens when the occipital nerves are irritated or injured. These nerves run from where the spine meets the neck up through the scalp at the back of the head.
The pain is often piercing, throbbing, or like an electric shock. It usually starts in the neck and spreads up, often on one side. Some people also feel pain in the scalp, forehead, or behind the eyes.
Symptoms
Pain can come in bursts or be constant.
- Sharp, shooting, or electric head pain
- Headache at the back of the head, usually on one side
- Headache on top of the head as pain spreads up
- Headache on one side of the head
- Tender scalp, sore to touch
Less common
- Pain behind the eye or in the forehead
- Eyes sensitive to light
- Pain behind the ear
- Numbness at the back of the head
How it usually goes
- Seconds to minutes: Bursts of sharp pain.
- Days to weeks: Pain may come and go.
- With treatment: Recovery is usually complete once the nerve heals.
Look up a symptom: Headache
When to get medical care
Causes
The nerves can be irritated by injury to the back of the head, tight neck muscles, neck arthritis, or keeping the head bent down and forward for long periods. Infection, gout, diabetes, and inflamed blood vessels are also linked. Often no cause is found.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Head or neck injury
- Neck arthritis
- Long periods looking down
- Diabetes or gout
Diagnosis
A healthcare professional asks about your pain and presses along the nerves.
Questions you may be asked
- What the pain feels like and where it spreads
- Past injury to the back of the head or neck
- Tight neck muscles or neck arthritis
- Health problems like diabetes or gout
The exam
They'll press on the back of your head to see if it brings on pain and check your neck.
Tests
Tests may include:
- Nerve block: A numbing shot near the nerve. Pain relief helps confirm the diagnosis.
- Imaging: To look for other causes in the neck.
Treatment
Many people improve with simple treatments.
Self-care
- Apply heat to the back of the neck
- Rest
- Get a gentle massage of tight neck muscles
- Avoid long periods with your head bent down and forward
Medicines
Some medicines need a prescription.
| Medicine | Helps with | Good to know |
|---|---|---|
| Anti-inflammatory pain relievers Ibuprofen | Pain | Follow the label. |
| Muscle relaxants | Tight neck muscles | Prescription. Take as directed. |
| Nerve blocks and steroid shots | Pain relief, sometimes long-lasting | A series of shots may be needed. |
| Nerve pain medicines | Severe or lasting pain | Prescription. Take as directed. |
If pain continues, your doctor may suggest nerve blocks or steroid shots near the nerve. Antidepressants may be used for severe pain.
How it compares
| Occipital neuralgia | Neck-related headache | Cluster headache | Trigeminal neuralgia | |
|---|---|---|---|---|
| Pain type | Electric, shooting | Aching, pressure | Severe, burning | Electric shocks |
| Where | Back of head, behind ear | Base of skull, up one side | Around one eye | Face and jaw |
Prevention
You may lower your risk:
- Take breaks from looking down
- Keep good posture
- Stretch tight neck muscles
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a neurologist (brain and nerve doctor).
Children, pregnancy, and older adults
- Office workers: Avoid keeping your head bent forward for long periods.
- People with diabetes: Diabetes is linked to this condition. Tell your doctor about new nerve pain.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
Outlook
Occipital neuralgia is not life-threatening. Many people improve with heat, rest, and medicine, and recovery is usually complete once the nerve heals.
Getting ready for your visit
Describe exactly what the pain feels like.
What to bring
- Where the pain starts and spreads
- What triggers it
- Past head or neck injuries
- Medicines you've tried
Questions to ask
- Is this occipital neuralgia?
- Would a nerve block help?
- What can I do at home?
- Do I need a scan?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Search ClinicalTrials.gov for studies on Occipital neuralgia
Sources
Last updated 2026-11-12.