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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Treatment For Occipital Neuralgia?

hi i am having very bad pain in my head n it is all my rite side i have had head scan n xrays n so on they r all clear i asked i dr on thise 2 help me and he said i had occipital neuralgia and i could get an injection 4 it but when i went 2 my GP who is not very helpfull he said he would not give me the injection he gave me lyrica 50mg 2 take 2 twice a day but they have done noting 4 me plz can u help
Mon, 17 Nov 2014
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Neurologist,  's  Response
I have gone through your query and I understand your concern.
Regarding the treatment of occipital neuralgia there are several options. Usually pharmacological treatment is tried first and if that fails or the drug is not well tolerated local nerve block (injection) is tried and lastly if nothing works surgery.
Lyrica is one of the first line drugs so I think it was correct to try it first. Since you say it isn't working perhaps it is time for the injection.
However 100 mg a day you have been taking is a low dose, so to be convinced it's not working you could try augmenting the dose first, at least 150 mg a day (50mg three times a day), can go to 300 mg a day maximum (that is if you don't have kidney impairmant or some other contraindication or adverse effect)
Hope to have been able to help you. Feel free to ask further questions.
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What Is The Treatment For Occipital Neuralgia?

I have gone through your query and I understand your concern. Regarding the treatment of occipital neuralgia there are several options. Usually pharmacological treatment is tried first and if that fails or the drug is not well tolerated local nerve block (injection) is tried and lastly if nothing works surgery. Lyrica is one of the first line drugs so I think it was correct to try it first. Since you say it isn t working perhaps it is time for the injection. However 100 mg a day you have been taking is a low dose, so to be convinced it s not working you could try augmenting the dose first, at least 150 mg a day (50mg three times a day), can go to 300 mg a day maximum (that is if you don t have kidney impairmant or some other contraindication or adverse effect) Hope to have been able to help you. Feel free to ask further questions.