What is The Occipital Nerve?

There are 3 occipital nerves called the greater, lesser and third occipital nerves. These spinal nerves are sensory and they provide sensation to the top and rear of the head and behind the ears. The 3 occipital nerves have no motor function.

The nerves originate from the upper cervical nerves and pass up through the base of the skull. The nerves run up alongside the neck muscles, behind the ears and finish at the scalp. 

When any of the occipital nerves get damaged it can lead to painful symptoms and a condition called occipital neuralgia. This condition has a variety symptoms and it affects the patients quality of life. Various things cause the condition including nerve compression, tightness of muscles, trauma, tumors and disease.

Occipital Nerve Injury

Any kind of trauma to the back of the head or neck can cause serious damage to the occipital nerve. Injuries sustained in car accidents or when playing contact sports can damage nerves. Accidental falls resulting in the head getting knocked can also damage the occipital nerve.

The trauma can lead to the occipital nerve getting pinched or trapped which will lead to symptoms developing. Some of the symptoms will be painful and many will affect day to day quality of life.

Nerve Compression

If an occipital nerve gets compressed it will not function and some symptoms will develop. A nerve can get compressed following injury, trauma or following neck surgery. Until the nerve is decompressed it will not function.


People with diabetes often suffer nerve damage and the occipital nerves are vulnerable. When blood flow to nerves gets affected by the disease, they are more susceptible to injury. The walls of blood vessels are also weaker in diabetic patients and this leads to nerve injuries. Medical studies have shown that diabetic patients are prone to various types of nerve injury.


Obesity, high blood pressure, high cholesterol and heart disease can cause and condition call gout. Gout causes sharp crystals to form in the joints due to excess uric acid in the blood. If these crystals form in the cervical spine region they can damage the occipital nerve.


Osteoarthritis affects millions of people and it’s the most common form of the disease. Patients with osteoarthritis can get nerve damage due to the occipital nerves getting trapped. The compression is sometimes caused when two pieces of bone continuously rub against each other due to the loss of cartilage.

Moreover, the occipital nerve can get damaged when spinal discs break down due to arthritis. The condition of spinal discs tend to deteriorate with age and the occipital nerve gets injured due to the deterioration.

Tight Muscles

Tight muscles in the back of the head or the neck can also damage the occipital nerves. Tight muscles often pinch the occipital nerve which compresses it and causes damage. 

Muscles can become tight when overworked as well as stress being a major cause of muscle tension. People who spend a lot of time working on computers and sitting at desks are prone to tight neck muscles.


Whiplash is a severe neck trauma usually sustained in a motor vehicle accident where the neck is forced forward then back suddenly. The extreme forces put on the neck during the collision often cause a lot of damage. Muscle tightness, ligament tears and inflammation all damage nerves in the neck. A whiplash injury can lead to occipital nerve damage due to the trauma.

Head or Neck Tumors

When a tumor is growing in the head or neck, damage to the surrounding tissue and nerves can occur. As the tumor grows, it puts pressure on the occipital nerve causing compression. Furthermore, tumors have been known to attach themselves to the occipital nerve which will cause problems. Tumors rarely damage the occipital nerve but it can happen.

When a doctor discovers a tumor in the head or neck they will attempt removal wherever possible. However, even when a tumor is removed, surgery can cause residual damage to the occipital nerve. In rare cases, the surgeon may also need to remove part of the occipital nerve in order to remove a tumor. 

Radiation and chemotherapy used to treat tumors can cause damage to nerves. High doses of radiation and potent drugs used for chemotherapy are designed to kill cancerous cells. An unfortunate side effect is that healthy cells, tissue and nerves may be damaged in the process    .


On occasion, the occipital nerve can get damaged during spine, neck or head surgery. All types of surgery carries risks and patients are made aware of any potential problems. The nerve may be damaged by the surgeon or it could be compressed following the operation. 

Scar tissue that’s formed following surgery often leads to damage of the occipital nerve. The fibrous tissue puts pressure on nerves which promotes compression.

Symptoms of occipital neuralgia and other injuries include:

  • Sharp pain in the head
  • Pain behind the eyes
  • Burning sensation
  • Neck mobility problems
  • Blurred vision
  • Tender scalp
  • Light sensitivity
  • Dizziness
  • Balance defects

Many of the symptoms are managed with rest and medication but the root cause of the injury needs to be found. A permanent solution can then be provided by a qualified doctor.

How is Occipital Nerve Damage Diagnosed?

woman with headache

Doctors have various ways to diagnose occipital nerve damage and it’s important the diagnosis is correct. Some nerve damage is mistaken for severe headaches or migraines due to the symptoms. The doctor will need to find where the damage is so that appropriate treatment is administered.

Doctors usually begin by asking the patient about their symptoms and they will carry out an examination. By pressing certain areas on and around the occipital nerve the injury can be detected. If the cause of the symptoms cannot be found there are some other tests that can be carried out.

Nerve blocking is a technique that involves injecting a nerve numbing substance into the painful area. If the symptoms ease after the injection it is likely that the nerve is injured. If the pain does not subside the problem is somewhere else. Nerve blocking is an effective way to diagnose nerve damage in many parts of the body.

Imaging tests are also used to diagnose damage to the occipital nerve. MRI and CT scans are used as well as ultrasound and X-rays. Imaging tests are particularly useful for looking at smaller nerves that are difficult to locate during a physical examination.

How Are Occipital Nerve Injuries Treated?

Warm compress to Womans neck

There are various ways that doctors can treat occipital nerve injuries and the treatment depends on the patients symptoms. The first course of action is too relax and release muscles that may be compressing the nerve. Using a warm compress is an effective way to relax muscles in order to free the nerve.

Muscle relaxants may be used in some cases to attempt to free an occipital nerve that is trapped. Patients could be prescribed some anti-inflammatory drugs and other medication to ease the pain associated with nerve damage. If non invasive treatments do not work and symptoms persist then alternative treatments may be needed.

Physiotherapy is often used to treat occipital nerve injuries and massage is particularly beneficial. Massage helps to stimulate blood flow in the area which aids the healing process. When nerves get a good supply of oxygenated blood they will heal better. Moreover, doing neck strengthening exercises helps promote stronger neck muscles which in turn, aids better posture.

Pulsed radiofrequency be used to help patients with the pain associated with occipital nerve damage. The procedure stops the nerves transmitting pain signals to the brain. This is a non invasive treatment and none of the surrounding tissue gets damaged.

Doctors can operate on the occipital nerve but will only do so when all other treatments have failed. A procedure called microvascular decompression is used to move encroaching blood vessels. The pressure on the nerve is then reduced and symptoms will ease.

Surgeons can also move the nerve in some cases so that it’s less likely to become trapped again. The nerve can also be removed but this leads to long term symptoms and is the last resort.

Final Thoughts

After reading the information about the occipital nerve it’s clear to see that any injury to it is going to cause pain and discomfort. Unfortunately most if the injuries to the occipital nerve cannot be avoided. Due to the fact that most damage is caused by accidents or disease most of the damage is unavoidable. The good news is that most occipital nerve injuries can be treated and no long term problems will arise.

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