What is occipital neuralgia? Occipital neuralgia is a disorder in which a problem with the occipital nerve in the back of the skull causes pain between the back of the head and the scalp, as well as pain, tingling, numbness, weakness, and possible damage to the nerves and muscles in the back of the neck. True occipital neuralgia is rare, especially compared to migraine headaches. Occipital neuralgia is most commonly the result of trauma, such as whiplash or surgery. However, anything that irritates or compresses the occipital nerve may cause occipital neuralgia, including tight muscles, arthritic inflammation of the cervical vertebrae, or a tumor. Risk factors for occipital neuralgia also include exposure to chemicals and diseases that impair the nervous system. The symptoms of occipital neuralgia can last from hours to days, with the disease course varying from person to person. Some people with occipital neuralgia have symptoms that disappear for long periods, while others may have symptoms that are so severe and frequent that they are disabling. A common symptom of occipital neuralgia is a headache with pain at the back of the neck and up the head to the scalp. Symptoms are most commonly felt on one side of the head, and if compression is prolonged, nerve damage may result in numbness and possible paralysis. Fortunately, occipital neuralgia can be treated successfully with analgesics (pain medicines) and pain-reducing therapies. In rare cases, surgical procedures may be performed to block signals from the occipital nerves that are involved. Seek immediate medical care (call 911) if you, or someone you are with, experience serious symptoms such as double or blurred vision, confusion or loss of consciousness for even a brief moment, weakness on one side of the body, or numbness or tingling in the arms or legs, as these may be signs of stroke. Seek prompt medical care if you are being treated for occipital neuralgia but symptoms recur or are persistent.