Chiropractic Care for Occipital Neuralgia

What is Occipital Neuralgia?

Occipital neuralgia headaches are very painful. There are, fortunately, many treatment options available to patients who suffer from these headaches. One such treatment option is chiropractic care. Occipital neuralgia (C2 neuralgia, Arnold’s neuralgia) causes chronic pain in the back of the head, behind the eyes, and in the upper neck. The occipital nerves actually contribute to the pain because they are damaged by physical stress, tumor, Radio Frequency nerve ablation, repetitious neck contraction, either flexion or extension, or external trauma, such as a concussive blow.

Symptoms of occipital neuralgia include chronic headache, pain around the back of the head or on top of the head, and pain behind the eye. The severe pain may originate at the upper neck, and it can be either one-sided or two-sided. Patients also often suffer from light sensitivity. Blurring of the vision might occur, and the pain the patient may experience could be sharp, stabbing, or like a shock. Patients may have discomfort while moving the neck, and they may suffer from having a tender scalp. The pain can be continuous, or it might last for only a few seconds.

Because it looks like other medical conditions, it is not uncommon for occipital neuralgia to be misdiagnosed and mistreated.¹ Occipital neuralgia comes from the irritation and compression of the occipital nerves. The nerves might be entrapped. Sometimes, no cause can be determined, but the general medical conditions that may display occipital neuralgia include osteoarthritis, cervical disc disease, infection, gout, diabetes, and neck tension.²

Text Neck

Another potential cause of this condition is excessive use of electronic devices paired with holding an improper posture for an extended period of time. “Text neck” is a condition where the patient has spent too long with their head down and spine hunched forward, often a position that they hold as a result of using a smartphone or tablet for an extended period of time. A similar problem could arise from reading for an extended time with the book positioned in the patient’s lap. The tightness in the front of the neck and weakness in the back from this improper posture could lead to occipital neuralgia.

In order to combat this particular cause of occipital neuralgia, patients should practice proper posture when engaging in regular activities, such as sitting upright and lifting the electronic device or book to eye level with the use of a stand or by holding it up by hand. Some patients might find it helpful to set up reminders on their phone or computer to regularly check their posture and get up every hour to take a break, walk around, and stretch out.³

Traditional Treatments

Standard medical treatment options for occipital neuralgia are analgesics, anti-inflammatory medication (i.e., NSAIDs), anti-convulsant medication, and migraine prophylaxis. Other medical treatments for occipital neuralgia may include local nerve block, steroids, rhizotomy, phenol injections, peripheral nerve stimulation, antidepressants, Occipital Cryoneurolysis, and surgical treatment methods.⁴

Exact diagnosis can be challenging for this disorder. Physical exam, blood tests, and MRI are three medical methods for diagnosis. Sometimes, however, doctors will provide an anesthetic nerve block to see if the pain subsides. If the latter idea for relief works, occipital neuralgia is suspected. Accurate diagnosis is critical to receiving the proper treatment. That’s because using the wrong methods of treatment is likely to waste time rather than provide any relief. For example, migraine treatments may not work on pain from occipital neuralgia. If the self-care and medication options do not work, surgeries like microvascular decompression or occipital nerve stimulation, may be indicated. In microvascular decompression, the doctor performs an adjustment of the blood vessels so that they do not compress the nerve. In the occipital nerve stimulation, electrical impulses are sent to stop the pain messages from getting to the brain.⁵

Chiropractic Alternative

Alternative treatments may hold answers for occipital neuralgia. Some patients respond to treatments like massage, physical therapy, yoga, rest, heat, acupuncture, and even chiropractic care.⁶ Medications can have side effects, and surgery carries its own set of complications. Some patients may not even obtain relief through traditional medical methods. Many believe that regularly taking medications to suppress the pain is an effective option. Though some medications might work to treat the condition, this might not hold true in all cases. Masking the side effects is not the same as treating the underlying condition.

Alternative care is focused on naturally treating the underlying condition and, with it, bringing a more permanent relief through treatment, recovery, and maintenance. Chiropractic care, being a practice known for following the complementary and alternative medicine (CAM) philosophy, aims to resolve underlying issues instead of temporarily relieving symptoms. Chiropractors have experience in treating pain caused by trauma, such as whiplash. They can also help to resolve neck pain, nerve entrapment, and muscle spasm issues. Some of the methods chiropractors might use for occipital neuralgia include traction, massage, heat, and “lift adjustments”.⁷