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​Occipital Neuralgia

What is Occipital Neuralgia?

Occipital neuralgia is a distinct type of headache characterized by sudden and recurring jabs of piercing, throbbing, chronic pain.

The pain originates from base of the skull and often radiates to the back, front, and side of the head.

It may also be present behind the eyes, in the upper neck, back of the head, and behind the ears, usually on one side of the head.

It usually causes extreme light sensitivity to the eyes. The pain is caused by irritation or injury to the occipital nerves.

Occipital neuralgia is typically treated nonsurgically, with the goal of alleviating the pain.

Depending on the person, doctors may offer several possible approaches to relieve pain, such as:

  • Physical therapy
  • Massage
  • Pain medications

If these treatments are unsuccessful, we can treat occipital neuralgia surgically.

Diagnosing Occipital Neuralgia

Testing to diagnose occipital neuralgia

Occipital neuralgia can be diagnosed by imaging studies such as CT and MRI scans.

Occipital neuralgia symptoms

Your doctor will also ask you about your symptoms.

These may include:

  • Sharp, stabbing head and neck pain that radiates from the base of the skull
  • Constant burning pain
  • Pain that is limited to one side of the scalp
  • Extreme sensitivity to light

Occipital Neuralgia Treatment

Pain management

Occipital neuralgia is typically managed without surgery, and may resolve with pain management techniques including:

  • Physical therapy
  • Massage
  • Medication


Surgical treatment depends upon the individual person, and may include:

  • Local injections 
  • Microscopic cervical spinal approach for ligation of the dorsal roots of the top two vertebrae (C1 and C2)

UPMC neurosurgeons may recommend a combination of surgical and nonsurgical approaches to occiptal neuralgia.

Neurosurgery at UPMC: A powerful team approach
Dr. Robert M. Friedlander discusses the team approach to treating neurosurgical patients.

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