Acupuncture for Occipital Neuralgia (ON)

By Dr. Louis Jin - The Woodlands Acupuncture & Herbal Clinic 

Occipital neuralgia is a condition characterized by chronic pain in the upper neck, back of the head, and behind the eyes. The pain is often described as sharp, stabbing, or like an electric shock. It is commonly confused with other types of headaches and neck pain, including tension headaches and migraines. In this blog post, we will explore the condition of occipital neuralgia, its signs and symptoms, etiology, standard treatment options, and how acupuncture and dry needling can offer relief by targeting suboccipital trigger points.

Occipital neuralgia is a condition characterized by unilateral or bilateral pain that specifically occurs in the distribution of the greater occipital nerve, lesser occipital nerve, and/or third occipital nerve.

The pain exhibits at least two of the following characteristics: it recurs in paroxysmal attacks lasting from seconds to minutes, is of severe intensity, and has a shooting, stabbing, or sharp quality.

Additionally, the pain is associated with dysaesthesia and/or allodynia, which become apparent during innocuous stimulation of the scalp and/or hair.

Tenderness over the affected nerve branches or trigger points at the emergence of the greater occipital nerve may also be present. The condition is distinctively eased, albeit temporarily, by a local anesthetic block of the affected nerve and is not better accounted for by another ICHD-3 diagnosis.

A diagnosis of occipital neuralgia includes a detailed medical history, neurologic exams, and in some cases an occipital nerve block to confirm the cause of pain.

Signs and symptoms of occipital neuralgia pain:

*Sharp, stabbing pain in the neck and back of the head

*Pain behind the eyes

*Sensitivity to light

*Scalp tenderness

*Pain when moving the neck

Occipital neuralgia is often caused by the pinching of the occipital nerves, possibly due to:

*Muscle tightness and spasms, particularly in the suboccipital muscles

*Trauma to the back of the head

*Arthritis affecting the upper cervical spine

*Tumors or other medical conditions affecting the neck

*Pain relievers or muscle relaxants

*Antidepressants for chronic pain

*Physical therapy

*Nerve blocks

*Surgical procedures like microvascular decompression, spinal cord stimulation, or occipital nerve stimulation

Acupuncture can be highly effective in treating occipital neuralgia and occipital nerve pain as it focuses on releasing suboccipital trigger points and surrounding neck tightness, which are often a significant source of pain in this condition. Acupuncture can also help relieve tight neck muscles that can lead to pinched nerve pain in the neck. Acupuncture offers the most conservative form of treatment when compared to an occipital nerve block or surgical treatment. A review on occipital neuralgia found that acupuncture shows promise as a first line treatment.

Trigger points in the suboccipital muscles can cause headaches and neck pain that radiate towards the eye and forehead. These trigger points are often activated by poor posture or muscle overload. By using acupuncture or dry needling to release these trigger points, one can alleviate the symptoms of occipital neuralgia if it is due to muscle tightness pressing on the affected nerve. The needles are inserted into specific points in the suboccipital region to stimulate the muscles and nerves. This helps in relaxing the muscles and improving blood flow, which in turn reduces pain and improves the range of motion in the neck and head.

Occipital neuralgia is a debilitating condition that can severely impact the quality of life. Understanding its symptoms and causes is crucial for effective treatment. Acupuncture offers a less invasive, more holistic approach to treating occipital neuralgia by targeting suboccipital trigger points, providing a significant relief from pain and improve the range of motion, offering a better quality of life for those suffering from this condition. Most patients undergo about 10 sessions of acupuncture (at 1-2 per week) for sustained relief for the occipital neuralgia. At The Woodlands Acupuncture, Dr. Louis Lei Jin specializes in treating all neuralgia and other neural dysfunctions of the human body, and usually get patients up and going sooner than expected.