“ Some patients may describe specific trigger zones at which stimulation immediately triggers a painful attack” onset occipital neuralgia, especially if abnormal neurological findings have been observed during the examination. Finally, patients with occipital neuralgia should respond to a diagnostic occipital nerve block. Occasionally, in very challenging cases, performing specific nerve block procedures may help differentiate between the pain from occipital neuralgia and the pain due to cervical spine abnormalities.
The pain associated with occipital neuralgia may be either acute or chronic. Acute pain, which represents the body’ s protective mechanism, signals that the stimulation that has been received is potentially damaging to the tissue. In response, the body will try to eliminate it. For example, patients who experience severe occipital pain( as in the case of occipital neuralgia) may suddenly put their head in a certain position to alleviate the pain; or, they may
stop the exact neck motion that produced the pain( such as straining the neck backwards). Most of these individuals may experience a sensation of tightness in the neck and shoulder areas or in the back of the head( occipital region). Instinctively, they may use muscle relaxants and / or anti-inflammatory agents to help reduce muscle tension, pressure, and localized swelling that may be causing or contributing to the compression of the greater or lesser occipital nerve. Once these protective mechanisms and actions have been utilized, the pain usually dissipates and may never re-occur unless a new injury is incurred.
Chronic pain occurs in those cases when the initial trauma has been resolved and the nervous tissue injury has healed, and yet the pain persists, and for the most part is unchanged. At this point, the chronic pain becomes the disease and not just a
12 HEAD WISE | Volume 3, Issue 1 • 2013