Understanding and Managing Occipital and Trigeminal Neuralgia

At Horizon Spine & Pain of Utah, we understand how debilitating nerve-related facial and head pain can be. Conditions like occipital neuralgia and trigeminal neuralgia can disrupt daily activities, sleep, and emotional well-being. Our experienced team specializes in diagnosing and treating these painful neurological disorders with precision and compassion—using advanced therapies to restore comfort and control.

Occipital neuralgia is a condition caused by irritation or compression of the occipital nerves, which run from the upper spine to the scalp. This condition leads to sharp, throbbing, or shock-like pain in the back of the head and neck.

Trigeminal neuralgia affects the trigeminal nerve, which carries sensation from your face to your brain. It can cause sudden, severe facial pain—often described as electric shock-like bursts—typically on one side of the face.

Although these are distinct conditions, both involve nerve dysfunction and require expert care for effective relief.

Occipital Neuralgia may result from:

• Trauma or injury to the back of the head or neck
• Pinched nerves due to arthritis, cervical disc disease, or muscle tightness
• Tumors, infections, or vascular compression (rare)

Trigeminal Neuralgia can be caused by:

• Blood vessel compression on the trigeminal nerve
• Multiple sclerosis or other demyelinating conditions
• Tumors pressing on the nerve
• Facial trauma or prior surgeries

Risk factors for both conditions include:

• Age over 50
• History of neck or head injury
• Chronic tension headaches or migraines
• Neurological disorders
• Diabetes or vascular disease

Identifying the underlying cause is key to selecting the best treatment path.

Occipital Neuralgia Symptoms:

• Intense, piercing pain in the back of the head, upper neck, or behind the eyes
• Pain often on one side, but may be bilateral
• Tenderness of the scalp
• Pain triggered by neck movement or pressure on the occipital area
• Sensitivity to light (photophobia)

Trigeminal Neuralgia Symptoms:

• Sudden, severe facial pain, often described as stabbing or electric shock-like
• Pain in the jaw, cheek, teeth, or around the eyes and lips
• Episodes triggered by everyday activities like brushing teeth, eating, or wind exposure
• Attacks lasting seconds to minutes, often recurring in clusters
• Possible facial twitching or spasms

Without proper treatment, these conditions can significantly impact daily functioning and mental health.

At Horizon Spine & Pain of Utah, accurate diagnosis is the foundation of effective treatment. We use a combination of:

• Detailed medical history and physical exam to assess pain patterns and nerve involvement
• Neurological testing to evaluate sensory responses and trigger zones
• Imaging studies:
  • MRI or CT scans to rule out structural causes like tumors, vascular compression, or MS
• Nerve blocks (diagnostic injections) to confirm the source of pain

Getting the right diagnosis helps ensure patients receive targeted, lasting relief.

Most patients benefit from a combination of conservative therapies, including:

Medications:

• Anti-seizure drugs (e.g., gabapentin, carbamazepine)
• Tricyclic antidepressants for nerve pain
• Muscle relaxants or anti-inflammatories for associated symptoms

Nerve blocks:

• Local anesthetic and steroid injections to calm inflamed nerves
• Both diagnostic and therapeutic in nature

Physical therapy:

• Gentle stretching, posture training, and neck strengthening for occipital neuralgia

Lifestyle modifications:

• Avoiding triggers, stress reduction, and ergonomic improvements

We customize each plan to the individual, ensuring optimal outcomes.

When conservative treatment is not enough, we offer cutting-edge pain management techniques:

• Radiofrequency Ablation (RFA):
  • Uses heat to disrupt nerve signals and provide long-lasting relief
• Botox Injections:
  • Shown to reduce nerve pain and frequency of attacks in some patients
• Peripheral Nerve Stimulation:
  • A small device implanted near the nerve delivers electrical impulses to block pain
• Occipital or Trigeminal Nerve Decompression Surgery:
  • Reserved for severe, refractory cases with structural nerve compression

Our goal is always to relieve pain using the least invasive approach possible.

Patients choose Horizon Spine & Pain of Utah for our:

• Board-certified specialists in neurology and pain medicine
• Comprehensive diagnostic capabilities
• Expertise in minimally invasive and image-guided procedures
• Personalized care plans and long-term support
• Commitment to restoring your quality of life

We focus on treating the root cause—not just the symptoms—so you can return to the activities and life you love.