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Headache & Facial

Migraine & Occipital Neuralgia

Migraine and occipital neuralgia can both cause severe head pain, but they stem from different sources and respond to different treatments. Migraines are a neurological condition often involving throbbing pain, sensitivity to light and sound, and sometimes visual disturbances, while occipital neuralgia is caused by irritation or compression of the occipital nerves at the base of the skull.

Migraine symptoms typically include moderate to severe throbbing pain, often on one side of the head, along with nausea and heightened sensitivity to light, sound, or movement. Occipital neuralgia, by contrast, tends to cause sharp, shooting, or electric-shock-like pain starting at the base of the skull that can radiate toward the scalp, sometimes with tenderness when touching that area.

Treatment depends on an accurate diagnosis. For occipital neuralgia, an occipital nerve block, a targeted injection of numbing medication and anti-inflammatory near the affected nerves, can provide both diagnostic confirmation and meaningful relief, often within minutes to hours. For chronic or frequent migraines, treatment may include a combination of nerve blocks, trigger-point injections for associated neck and shoulder tension, and coordination with medication management for prevention.

Because head pain can have overlapping causes, our evaluation focuses on identifying the specific pattern and triggers behind your symptoms before recommending treatment, so you’re not just managing pain, but addressing what’s actually causing it.

Frequently Asked Questions

How can I tell if my headaches are migraines or occipital neuralgia?

Migraines typically cause throbbing pain with nausea and sensitivity to light or sound, while occipital neuralgia causes sharp, shooting pain starting at the base of the skull. An exam and, if needed, a diagnostic nerve block can help confirm the source.

How quickly does an occipital nerve block work?

Many patients experience relief within minutes to hours of the injection, though the duration of relief varies. Some patients need a short series of blocks for longer-lasting results.

Can chronic migraines be managed without daily medication?

For some patients, nerve blocks and trigger-point injections can reduce migraine frequency and severity, potentially reducing reliance on daily medication, though this depends on your specific pattern of migraines and should be discussed with your provider.

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