This headache is caused by the occipital nerves and requires different treatment than migraine. If e.g. migraine medicine isn't working, your recurring headaches may not be migraines after all. Occipital neuralgia can be confused with migraine because the symptoms can be similar. They include:

• Pain, or burning at the base of your head up to your scalp.

• Sharp, shock-like or piercing pain in upper neck and back of head.

• Pain on one or both sides of your head

• Tenderness in the scalp

• Pain when rotating the neck

But that's where the similarities end. Occipital neuralgia and migraines require different treatments because their sources of pain are different. Migraines are associated with changes in the brain. Occipital neuralgia is caused by compressed or irritated nerves that run from the neck to the back of the skull. Nerves can become irritated due to a muscle spasm or trauma to the head or neck. Sometimes we don't know what's causing it.

The difference between occipital neuralgia and migraine

Migraines tend to have recognizable triggers. They can be accompanied by visual disturbances and other symptoms that precede headaches. Occipital neuralgia, on the other hand, typically has none of these characteristics. Pain specialists can identify occipital neuralgia by one or more of these methods:

→ Patient history. If the pain starts in the neck and radiates from the head to the eyebrows, this is typical occipital neuralgia.

→ A basic exam. Doctors can sometimes reproduce the pain by pressing on the occipital nerves at the base of the skull.

→Nerve blockade. If the pain goes away after numbing the occipital nerve, then we can be sure that occipital neuralgia is causing the headache.

How to treat occipital neuralgia

Oral anti-inflammatory medications are the first step in treating occipital neuralgia, but they are usually not effective. Using heat or massage to soothe the neck muscles can also help. Neuropathic pain medications also usually help. If these treatments do not provide relief, invasive procedures can perform an occipital nerve block. A local anesthetic and steroid is injected around the irritated nerve. Pain relief can last from several weeks to several months, and sometimes the pain does not return. If your headaches persist for more than three months and haven't responded to conventional migraine treatments it's time to see a doctor.