Home
/
/
Condition

Occipital Neuralgia

Occipital neuralgia causes sharp, electric pain at the base of the skull that shoots up into the scalp. It often gets mistaken for migraine or tension headache.

Overview

The occipital nerves run from the upper neck up through the scalp. When they are irritated or compressed, they fire off pain signals that feel like a jolt at the base of the skull, often spreading over the top of the head or behind the ear.

Common causes include whiplash, tight neck muscles, past head or neck injuries, and arthritis in the upper cervical spine. Targeted treatment aimed at the occipital nerves themselves is usually much more effective than headache medications.

Symptoms & causes

The pain pattern is the biggest clue. Occipital neuralgia feels very different from a typical headache.

Sharp, electric, or shooting pain starting at the base of the skull
Pain that travels up the back of the head, behind the ear, or across the scalp
Tender spots at the base of the skull that hurt when touched or pressed
Light sensitivity, neck stiffness, or scalp tenderness

When to see a doctor

Seek care if…

Call us if the pain changes character suddenly, if you develop neurological symptoms like vision changes or weakness, or if pain follows a recent injury. These can signal a different problem that needs same-day attention.

Frequently asked questions

Is occipital neuralgia the same as a migraine?

No. Occipital neuralgia is a nerve pain condition with a specific pattern: sharp, shooting pain from the base of the skull. Migraines are a neurological condition with throbbing pain, nausea, and light or sound sensitivity. Some people have both.

How long does relief from an occipital nerve block last?

Most patients get two to twelve weeks of relief from a nerve block. For patients whose pain keeps returning, radiofrequency ablation can extend relief to six months or longer.

Do I need imaging before treatment?

Sometimes. If your exam fits occipital neuralgia cleanly, we can start with a diagnostic block. If there are any red flags or the pattern is unusual, we will get an MRI of the neck first.