• 08 Oct, 2026
• UnityPain
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Occipital Neuralgia & Injection Treatment | Unity Pain

When the Back of Your Head Won’t Stop Hurting

If you feel sharp, shooting, or electric pain starting at the base of your skull and spreading up toward the top of your head, you are not alone. This kind of pain can be frightening and exhausting. It can make it hard to turn your head, sleep at night, or get through a normal day. What you may be experiencing is called occipital neuralgia — a condition that affects the nerves running from the back of your neck up through your scalp. The good news is that this condition is recognized, treatable, and manageable with the right care.

Living with head pain that comes on suddenly and without warning is deeply stressful. Many people with occipital neuralgia spend months or even years searching for answers before getting a proper diagnosis. If that sounds like your story, please know that help is available and that real, meaningful relief is possible with the right treatment plan.

What Is Occipital Neuralgia?

Occipital neuralgia is a type of headache disorder caused by irritation or injury to the occipital nerves. These are nerves that run from the top of your spinal cord, through the muscles at the base of your skull, and up over your scalp. When these nerves become inflamed, compressed, or damaged, they can send pain signals to the back of your head, behind your ears, and even behind your eyes.

The pain from occipital neuralgia is often described as stabbing, piercing, or like an electric shock. It may come in short bursts or stay for longer periods. Some people also feel tenderness when touching their scalp, or sensitivity to light. It is sometimes confused with migraines or tension headaches, which is one reason it can take time to get the right diagnosis.

Common causes include muscle tightness in the neck, injury to the head or neck, arthritis in the upper spine, pinched nerves, and even staying in one position too long. Understanding the cause of your specific pain is an important first step toward feeling better.

How Is Occipital Neuralgia Diagnosed?

A doctor will usually diagnose occipital neuralgia by listening carefully to your symptoms and doing a physical exam. They may press on areas at the base of your skull to see if that triggers your pain. Imaging tests like an MRI or CT scan are sometimes ordered to rule out other causes, such as problems in the spine or brain.

One of the most important diagnostic tools is also a treatment tool — a nerve block injection. If a small injection of numbing medicine near the occipital nerve brings you significant relief, that strongly suggests occipital neuralgia is the cause. This is one of the reasons that working with a pain specialist is so valuable. They can use the right tests and techniques to confirm what is going on and start moving toward solutions right away.

Injection Treatments for Occipital Neuralgia

One of the most effective and commonly used treatments for occipital neuralgia is an occipital nerve block. This is an injection given near the greater or lesser occipital nerves at the base of the skull. The injection usually contains a local anesthetic, a corticosteroid, or both. The anesthetic works quickly to ease pain, while the steroid helps reduce inflammation around the nerve over time.

Many patients feel relief within a short time after the injection. The length of relief can vary — some people feel better for weeks, and others for several months. Nerve block injections can be repeated if the pain returns, and they are often used alongside other treatments like physical therapy or medication. They are generally well tolerated and can be done in a clinic setting without a long recovery time.

In some cases, trigger point injections may also be helpful. These target tight muscle knots in the neck and upper back that may be pressing on the occipital nerves. Treating the muscles around the nerve can reduce tension and help the nerve calm down. A pain specialist can evaluate which type of injection is most appropriate based on your individual situation.

Other Ways to Manage Occipital Neuralgia

Injections are often a key part of care, but they usually work best as part of a broader treatment plan. Medications such as muscle relaxants, anti-inflammatory drugs, or certain nerve pain medications may help reduce flare-ups. Your doctor may also recommend non-steroidal anti-inflammatory drugs, or NSAIDs, to manage day-to-day pain.

Physical therapy can be very helpful for addressing the muscle tightness and posture problems that often contribute to occipital neuralgia. A physical therapist can teach you stretches and exercises that ease pressure on the nerves in your neck. Simple changes in how you sit, sleep, or hold your phone can make a real difference over time.

Heat applied to the base of the skull and neck, gentle massage, and rest during flare-ups are also common self-care strategies. While these do not replace medical treatment, they can offer comfort while you work with your care team on a longer-term plan. Always discuss any home remedies with your provider before starting them.

Getting the Right Help for Head and Neck Pain

Occipital neuralgia is a real, recognized medical condition — not something you have to simply push through. If you have been struggling with pain at the back of your head or neck, a proper evaluation by a pain specialist is an important step. Getting the right diagnosis opens the door to targeted treatments that can actually address the source of your pain.

At Unity Pain Management in Modesto, CA, our team works with patients to find the cause of their pain and create a personalized care plan. We offer nerve block injections, trigger point injections, medication management, physical therapy referrals, and telehealth visits. We are insurance-friendly and here to make care as accessible as possible.

A Message of Hope

Living with head pain can wear you down emotionally as well as physically. It affects your sleep, your relationships, and your ability to enjoy your life. Please know that you deserve care, answers, and relief. Many people with occipital neuralgia do find meaningful improvement with the right treatment approach.

You do not have to keep searching alone. Reach out to a pain specialist, ask questions, and advocate for yourself. Relief may be closer than it feels right now.

References

• Headache Classification Committee of the International Headache Society. “The International Classification of Headache Disorders, 3rd Edition.” Cephalalgia. 2018.
• Vanelderen, Pascal, et al. “Occipital Neuralgia.” Pain Practice. 2010.
• National Institute of Neurological Disorders and Stroke. “Occipital Neuralgia.” National Institutes of Health. 2023.
• Pingree, Matthew J., et al. “Occipital Nerve Stimulation for the Treatment of Occipital Neuralgia.” Mayo Clinic Proceedings. 2017.
• Barmherzig, Rebecca, and Jessica Kingston. “Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management.” Current Neurology and Neuroscience Reports. 2019.