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Occipital Neuralgia Cervical Facet Syndrome

Occipital neuralgia is a type of a headache that becomes worse with movement. It is often centered toward the back of the eyes, but is generally difficult to distinguish from other types of headaches. The primary nerves involved include the posterior occiput. Pain from occipital neuralgia cervical facet syndrome can be extremely difficult to manage and may even be debilitating for some individuals. Treatment often includes the use of nerve blocks at either the C2 or C3 nerve roots or possibly both.

  1. About

    • According to an article in Pain Management Rounds by Steven Barna, MD and Maliha Hashmi, headaches account for approximately 20 million doctor visits a year. Occipital neuralgia is a headache that often is similar to that of a tension headache in which the pain feels like pressure in the head and is centered behind the eyes. Headaches can be divided into primary and secondary headaches. Primary headaches will have no specific underlying etiology or cause (migraine, cluster, tension). Secondary headaches are related to a specific underlying cause such as a tumor, trauma, systemic disease, infection or hemorrhage.

    Facts

    • According to Barna and Hashmi, occipital neuralgia is usually due to structural damage. This can include damage that is the result of head trauma or tumors that may be growing within the brain structure. Generally, structural damage occurs in the C2/C3 area of the spine, which is located almost immediately adjacent to the base of the head and neck where they come together.

    Causes

    • Generally, occipital neuralgia cervical facet syndrome is the result of major trauma to the head and neck or compression of the spine in the C2/C3 area of the spine. According to Barna and Hashmi, as the occipital nerve is affected, the pain travels down the nerve to the surrounding muscles. Whiplash is often a trigger for occipital nerve pain, as is the growth of tumors that press down upon the occipital nerve or spinal degeneration conditions which result in changes in the spine.

    Symptoms

    • The symptoms of occipital neuralgia are very sensate in nature. Barna and Hashmi describe burning sensations on the skin, throbbing pain and aching in the affected area. Addition symptoms can include intermittent shocking or shooting pain that travels from the neck up into the head. Usually the pain and sensations are on one side of the neck area and head and are continuous except for the shooting pain sensation.

    Treatments

    • Generally, the primary treatment is through medication, particularly if there is no specific structural damage or trauma that points to a cause. Barna and Hashmi state that gabapentin (Neurontin) is often the drug of choice for treatment of occipital neuralgia cervical facet syndrome. Other medications that are used are NSAIDs and opiates. Other treatments include surgery to correct structural problems and the use of nerve blocks to stop pain.

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