Occipital Neuralgia & Cervicogenic Headaches
Two nerve-based head pain conditions that are frequently misdiagnosed as migraines — and that respond well to targeted interventional treatment once the correct diagnosis is established.
Understanding These Conditions
Occipital neuralgia develops when the greater and/or lesser occipital nerves — which travel from the upper cervical spine through the scalp — become irritated or inflamed. The resulting pain is sharp, stabbing, or electric shock-like, and typically radiates from the base of the skull upward through the scalp, sometimes reaching behind the eye. Pressure over the nerve pathway on the back of the skull is often painful on examination. Because the pain can be severe and unilateral, it is frequently mistaken for migraine — and standard migraine treatments often fail to provide meaningful relief.
Cervicogenic headaches originate from structures in the cervical spine — most commonly the upper facet joints — and refer pain into the head. The pain is typically one-sided, begins in the neck, and radiates forward to the forehead or behind the eye. Cervicogenic headaches are often worsened by neck movement or sustained positions, and respond to treatments directed at the cervical spine rather than headache medications.
How We Treat These Headaches
For occipital neuralgia, occipital nerve blocks are typically the first interventional step — providing both diagnostic confirmation and meaningful therapeutic relief. A series of blocks is often more effective than a single injection. For patients with severe, refractory occipital neuralgia, peripheral nerve stimulation targeting the occipital nerves offers a longer-term option. Radiofrequency ablation of the greater occipital nerve may also be appropriate in select cases.
For cervicogenic headaches, cervical medial branch blocks can confirm whether the upper facet joints are the pain source, followed by cervical medial branch radiofrequency ablation for longer-lasting relief. A consultation will determine the most appropriate diagnostic and treatment pathway for your specific headache pattern.
Common Questions
Headaches That Start in Your Neck?
Our clinical team can evaluate whether occipital neuralgia or cervicogenic headaches are contributing to your pain — and recommend a targeted treatment plan.