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How Does Occipital Neuralgia Differ from Cluster Headaches?

Women Clinching Her Neck

There is a common misconception that occipital neuralgia is the same condition as a cluster headache, and the painful symptoms between the two conditions are often confused.

However, there are important distinctions that need to be made between the symptoms and causes of these two serious conditions so that proper treatment can be pursued.

Here is a discussion of what occipital neuralgia is, how its symptoms differ from cluster headaches, and how they both can be treated.

Understanding Occipital Neuralgia

Occipital neuralgia typically occurs because of a pinched nerve root in the neck which can result from an injury or surgery. The condition involves occipital nerves, the nerves that extend from the scalp down to the top of the spinal cord, becoming injured or inflamed. This condition is rare, but it is often confused with other types of headaches, including cluster headaches.

With occipital neuralgia, the scalp may become overly sensitive to the touch, which makes simple tasks like lying down excruciatingly painful. Some types of headaches, such as migraines, can inflame the occipital nerve, but this is still considered to be a migraine for diagnosing and treatment purposes.

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Conditions and Attributes of Occipital Neuralgia

The pain associated with occipital neuralgia is often described as sharp, shocking, or jabbing pain in the neck and back of the head. One related symptom may be pain behind one eye, which is why this condition is misinterpreted as a cluster headache. Cluster headaches almost always feature one-sided pain and stay on just one side of the head during the duration of the event. However, cluster headache pain is typically described as feeling like a burning, constant, and throbbing sensation.

One can differentiate the symptoms because occipital neuralgia generally originates at the base of the skull and radiates near the back or along the side of the scalp. Meanwhile, cluster headaches are felt mostly behind one eye and usually only spread to the forehead, temples, nose, and cheek. Most people experience occipital neuralgia attacks as episodes that only last between a few seconds to a few minutes. But on the other hand, cluster headaches usually last for 30 to 90 minutes on average but can occur an additional time or two per day in some cases.

Treatments for Occipital Neuralgia

Treatments for each of the conditions discussed here are very different, and implementation of the correct treatment is necessary for relief.

For occipital neuralgia patients, doctors often inject a local anesthetic or steroid into the occipital nerve area to stop the pain. This treatment may prevent the pain from coming back for a period of time, but the pain often comes back, requiring additional injections. In severe cases where periodically numbing the nerve is ineffective, treatment options include surgically cutting off the nerve, burning it with a radio-wave probe, or using neuro-stimulators to block pain messaging to the brain. Some patients have also found relief with more natural and non-surgical treatments like physical and massage therapy or medications that have anti-inflammatory and muscle relaxing properties.

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