Sharp, shooting pain that runs from the base of the skull up the scalp, along the occipital nerves. When blocks and medication aren't enough, neuromodulation and decompression can help.
Occipital neuralgia is sharp, shooting or electric pain that begins at the top of the neck or the base of the skull and travels up the back and side of the scalp, following the greater and lesser occipital nerves. The scalp over the nerve is often tender, and the area can feel unusually sensitive to touch. It can follow a whiplash injury, chronic muscle tightness, or entrapment of the nerve as it passes through the neck muscles.
Treatment starts conservatively, medication, physical therapy, and addressing posture and muscle tension. A diagnostic occipital nerve block is an important step: if numbing the nerve briefly relieves the pain, that both confirms the nerve is the source and predicts who is likely to benefit from a procedure. Surgery is considered when the pain is disabling and keeps returning despite these measures.