Occipital Neuralgia

occipital neuralgia flow osteopathy
Melbourne osteopath Tim discusses occipital neuralgia and how treatment can help.

Occipital neuralgia is a type of headache in which the nerves that supply sensation to our scalp (the occipital nerves) become sensitive and generate pain. Given the location of the pain, it can be misdiagnosed as a more common condition such as tension type headache or migraine.

We’re going to look at the different ways you can tell occipital neuralgia apart from common types of primary headache conditions.

Characteristics of Occipital Neuralgia

Generally, the pain associated with occipital neuralgia will be felt in the top of the neck, back of the head and behind the ear, usually on one side. The nature of the pain is often described as ‘sharp’, ‘stabbing’ or like an ‘electric shock’.

Onset of the Pain

More often than not there is no clear onset of the pain associated with occipital neuralgia. That said, it can begin as a result of direct trauma, osteoarthritis, diabetes and tension in the neck muscles.


If the occipital nerves are inflamed or injured, the diagnosis will often be made based on the characteristics of the pain as well as a physical examination. Sometimes an MRI is required to help determine what might be causing the nerves to become painful.

One way of differentiating this type of headache from similar types is with an anesthetic block. This is where a doctor, generally a pain specialist, will inject a nerve block into the occipital nerve and see if the pain goes away.


Often occipital neuralgia can be managed with conservative measures, such as manual therapy and exercises. The occipital nerve block, which is used to help diagnose occipital neuralgia can also be used as a treatment method.

At Flow Osteopathy we can perform a detailed examination of the upper neck to determine if there is muscle spasm and joint restriction that is contributing to the irritation of the occipital nerves. We use the Watson Headache Approach for treatment, which is a gentle, hands on approach that has been scientifically validated for treatment of a variety of headache types.

Find out more on our headache & migraine page

  1. American Association of Neurological Surgeons, ‘Occipital Neuralgia’.
  2. National Institute of Neurological Disorders and Stroke, ‘Occipital Neuralgia’.
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