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Dr. Andrew Rynne

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What causes pain in upper neck, back of head and behind the eyes?

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Dr. Karl Logan

Orthopaedic Surgeon

Practicing since :1999

Answered : 705 Questions

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Posted on Fri, 23 Oct 2015 in Back Pain
Question: Yes. I have been experiencing sharp pain which radiates from the base of the rear of my skull down my neck to my shoulder. It seems to intensify if I am under some type of stress or drink too much caffeine.

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Answered by Dr. Karl Logan 13 minutes later
Brief Answer:
Occipital neuralgia

Detailed Answer:
Hi,

Thanks for your question. Your symptoms sound consistent with occipital neuralgia.

Occipital neuralgia, also known as C2 neuralgia, or (rarely) Arnold's neuralgia, is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. The greater occipital nerve also has an artery that supplies blood that is wrapped around it - the occipital artery - that can contribute to the neuralgia. This condition is also sometimes characterized by diminished sensation in the affected area as well.

The main symptom of this condition is chronic headache. The pain is commonly localized in the back and around or over the top of the head, sometimes up to the eyebrow or behind the eye. Because chronic headaches are a common symptom of numerous conditions, occipital neuralgia is often misdiagnosed at first, most commonly as tension headache or a migraine leading to unsuccessful treatment attempts. Another symptom is the eyes being sensitive to light, especially when headaches occur.

Occipital neuralgia is characterized by severe pain that begins in the upper neck and back of the head. This pain is typically one-sided, although it can be on both sides if both occipital nerves have been affected. Additionally, the pain may radiate forward toward the eye, as it follows the path of the occipital nerve(s). Individuals may notice blurred vision as the pain radiates near or behind the eye. The neuralgia pain is commonly described as sharp, shooting, zapping, an electric shock, or stabbing. The bouts of pain are rarely consistent, but can occur frequently with some patients depending on the damage to the nerves. The amount of time the pain lasts typically varies each time the symptom appears; it may last a few seconds or be almost continuous. Occipital neuralgia can last for hours or for several days.

Once diagnosed, occipital neuralgia's symptoms can be treated/managed in several ways. There are a wide range of non-invasive treatments, including alternative treatments, which are as follows: acupuncture, chiropractic manipulation, occupational therapy, osteopathic manipulation, naprapathic treament, massage, yoga, physical therapy, rest, heat, anti- inflammatory medication, antidepressant medication, anti- convulsant medication, opioid and nonopioid analgesia, and migraine prophylaxis medication. Alternatives to these may include local nerve block, peripheral nerve stimulation, steroids, rhizotomy, phenol injections, antidepressants, and Occipital Cryoneurolysis.

Other less common forms of surgical neurolysis or microdecompression are also used to treat the condition when conservative measures fail.

I hope this helps answer your question.

Best wishes


Above answer was peer-reviewed by : Dr. Vaishalee Punj
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