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What is the Occipital Nerve?

By C. Martin
Updated Mar 03, 2024
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In human biology, the occipital nerve refers to one of two main nerves of the spine, specifically called the greater and the lesser occipital nerve. Both are important in supplying nerve connections to the head and scalp. They originate between the second and third vertebrae of the spine. The greater nerve supplies the top of the scalp, and the area of the head above the ears and over the salivary glands. The lesser one supplies the back of the scalp, in the area behind the ears.

If one or both of the nerves are damaged, the resulting disorder is called occipital neuralgia. Some common ways in which the nerves may be damaged include physical trauma such as blows to the head or neck, whiplash, and some excessively repetitive neck movements. In addition, neuralgia may result as a complication of some other medical conditions, such as a tumor in the spinal bone or various types of arthritic conditions. Pain in this nerve is normally experienced in the form of chronic headaches. They may be accompanied by chronic neck pain and pain behind the eyes, as well. Patients may also report an increased sensitivity to light.

Occipital neuralgia may be treated with certain medicines designed to reduce the activity in the occipital nerves. Another treatment is a nerve block, which involves an injection at the base of the skull. The drug used in the injection is usually a steroid, accompanied by a painkilling drug, which provides a temporary anesthetic effect. The treatment aims to reduce inflammation and pain in the nerve. The anesthetic from the treatment may greatly reduce the patient’s pain quickly, while the steroid acts more slowly, but may have a beneficial effect lasting for several months.

Treatment of the occipital nervous system is sometimes used for other conditions, such as migraines, tension headaches, or other chronic headaches. One such treatment is occipital nerve stimulation, in which a tiny transmitter device is implanted at the base of the skull, near these nerves. The device sends electrical signals to the nerves at regular intervals, acting almost like a pacemaker. The signals from the transmitter are designed to mask the headache pains.

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Discussion Comments

By anon1004181 — On Dec 05, 2020

I was diagnosed with bilateral occipital neuralgia in 2015 after a car accident. Intense pain back of head along with burning pain. Some shape pain in head. Felt like electric shock. Eye pain and severe migraines and my forehead had gone numb and burn like hot grease. After several months of agony and treatment I went to a pain specialist. He suggested Botox for the migraines and chiropractor. Over the course of a few months the headaches improved along with all the other pain issues I was dealing with. Botox every three months and chiro. Once a week to begin with. It change my life. Something you might try before a nerve block.

By anon927172 — On Jan 22, 2014

It has been a week since I had occipital nerve block injections and I am still dizzy and feel weird in my head. There is an area on the right hand side of my head which is numb and I have painful nerve tingling over my scalp. None of these I experienced before the nerve blocks. I am quite worried. Anybody thinking of having them done please make sure you discuss all possible options with your doctor.

By anon283612 — On Aug 05, 2012

I am 39 and woke up 3 months post op shoulder surgery to a debilitating pounding in the occipital part of my head. I do have old trauma in the cervical area. The C5 and 6 were removed three years ago

I see a neurologist soon for this problem. My shoulder surgeon ended up giving me four cortisone shots in the trigger point of my neck because my neck was spasming. The shots took the headache away but I'm not out of the woods yet. I still feel brain dead since the headaches. Is it because the nerves in the cervical area that are ruined I wonder?

By anon205940 — On Aug 14, 2011

Had an occipital block done about four days ago, The shot really didn't hurt too bad, It was just weird being in the head. I'm still sore and I do have some throbbing, but hopefully this will work. I couldn't handle the pain anymore and try to work! My doctor was awesome! We'll see if this will work.

By anon173009 — On May 05, 2011

I've been offered the nerve block injection but have to wait four months. Also upon research it seems it is not guaranteed to help with the pain but in fact can make things worse. I therefore decided to try acupuncture. Its the best thing ever for me!

The therapist used electrical currents with the acupuncture and I am going to stick with this if I need a top up. Had two treatments so far and things are fab.

By anon168143 — On Apr 15, 2011

My daughters mother-in-law had this treatment done a few days ago in Fort Smith Ark. She left the clinic and went into respiratory distress. Her mother was driving her and became concerned when she lost consciousness and began having labored breathing, and she called the clinic to ask the doctor what to do, and he told her to return to the clinic immediately.

By the time they arrived she was barely breathing and would still not wake, so he called an ambulance, they took her to the nearby hospital and she was immediately put on life support. They did not have the staff and had to transport her to the only other hospital in fort smith. The last couple of days have been horrible. She still has not come out of it, and the doctors think she is brain dead from being deprived oxygen. They called the family to the hospital because her organs are failing. this kind woman was only 45 and suffered migraines and was otherwise healthy, and this evening her family has to consider turning off her life support.

By anon141595 — On Jan 10, 2011

I had migraines my whole life and no medication worked so the doctors gave me the nerve blocks -- a total of 13 shots -- in both sides of my head, neck and back.

It's six months later and I now have occipital pain so bad in the back of my head that was caused from those injections. My nerve is now damaged and my head is always in burning pain and now I have to go back to see the neuro next week for this problem, not my migraines.

So make sure it's a good doctor doing your injections. It might not be worth it. It wasn't for me.

By anon135151 — On Dec 17, 2010

My mom had a tumor in the C2-C5 area a couple years back and had surgery to remove most of it. Radiation therapy was done on this to kill the remainder post-surgery. As a result, i believe my mom has neuralgia due to the shooting pain. She is scheduled to get a occipital nerve block injection this monday. Is it safe for her to get this injection? Thanks so much for your help and time!

By anon132452 — On Dec 06, 2010

Is there any other durable and permanent solution to lesser occipital neuralgia other than pain management pills or steroids injection? And is there any research taking place for this purpose?

Please let me know as I also suffer badly from this ailment as a result of a head blow. I do not want to go for the above two mentioned solutions.

By anon116394 — On Oct 06, 2010

Two weeks post nerve block for occipital neuralgia (mainly left sided). there has been minimal improvement, but I think the trauma of the needle insertion flared things up and once the anesthetic wore off I really felt it for the first week or so! Side effects for the first few days, nausea, insomnia and feeling 'off'. Hoping that, together with Duloxtine, things will start calming down now in the head and neck area. Bing again.

By anon112483 — On Sep 20, 2010

I did it! I was worrying furiously over past few months about left sided occipital nerve block for whiplash induced occipital neuralgia (anesthetic and cortisone). Went to hospital and had it done today (no numbing prep!!) was terrified. I swore a few times (not like me at all) as the needle was inserted, boy it hurt but only lasted 10-15 seconds.

Waiting for the anesthetic to wear off, have the paracetamol at the ready but looking forward to a few weeks/months of pain easing up (worried slightly about oncoming cold season as this makes it worse). Go for it all you sufferers, it will not kill you. We have to hope there is something out there to help us cope with this awful condition. (And ladies, childbirth is far worse!) Bing

By anon108939 — On Sep 05, 2010

I have had five rounds of blocks, usually three in the skull and pinpoints on the neck. Headaches are gone. They usually start back month later in full force. My doctor is great. The steroid makes me meaner than hell. it is a relief from headaches but keeping control of yourself is challenging.

By pharmchick78 — On Jul 21, 2010

@EarlyForest -- The procedure is pretty simple. When you go in to your doctor's, they will have you either sit or lie down.

Then they will clean the injection site (just like when you give blood), and inject a local anesthetic and steroids.

The injection itself is a little painful, since it has to go so deep, but the pain won't last long.

After the injection you can go home, but you should take it easy for the rest of the day.

Once the anesthetic wears off, you'll feel some pain at the injection site, but by the third day or so the steroids will kick in and you'll be feeling good!

By EarlyForest — On Jul 21, 2010

I am having a greater occipital nerve block next week to try and help with my darn migraines.

Can anybody tell me what to expect?

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