Acupuncture is a potential treatment for occipital neuralgia for the relief of pain and improvement of well-being.

Occipital neuralgia is a type of headache associated with irritation or injury of the occipital nerves. The greater, lesser, and third occipital nerves run through the scalp and spine. Occipital neuralgia is characterized by extreme pain that can radiate through the head and neck. Acupuncture for occipital neuralgia is relatively under-studied, however promising results have been reported.

What causes occipital neuralgia?

Occipital neuralgia can be directly caused by, but not limited to:

  • Blunt trauma to the back of the head or neck
  • Pinched nerves at the back of the neck
  • Tight neck muscles

Occipital neuralgia may arise from, but not limited to:

  • Underlying disease, such as osteoarthritis, gout, or diabetes
  • Infection
  • Tissue inflammation
  • Tumors affecting the occipital nerve roots

How is it diagnosed?

Diagnosis of occipital neuralgia involves a physical and neurological exam. An MRI may be required to reveal a pinched nerve, or a CAT scan to reveal detailed images of the spine and nearby structures.

What are the current treatments?

Unfortunately, there is no cure for occipital neuralgia. The goal of therapy is to alleviate the pain through non-surgical and surgical treatments.

Non-surgical treatment options include:

  • Over-the-counter heating pads placed onto the affected areas for relief
  • Physical or massage therapy
  • Oral medications, such as ibuprofen, acetaminophen, muscle relaxants, and anti-seizure medications to relieve inflammation and pain
  • Botox injections to reduce nerve inflammation
  • Occipital nerve block uses an injection mixed with a numbing and steroid agent to reduce the inflammation and pain

Surgical treatment options include:

  • Occipital nerve stimulation is currently being researched as a potential treatment. A device uses electrodes to produce electrical impulses near the occipital nerves.
  • Spinal cord stimulation also uses electrodes to help reduce the pain.
  • C2,3 ganglionectomy involves the removal of the nerve roots. A 2008 study found that 95% of patients had instant relief, but 60% reported that the relief lasted past one year.

Alternative treatment for occipital neuralgia

Another alternative treatment for occipital neuralgia is acupuncture. Acupuncture is Chinese medicine that stimulates the flow of Qi (pronounced, chee) energy. Qi is the body’s healthy energy and must flow freely through the body. If the Qi is not balanced, then the is vulnerable to disease and illness. Acupuncture claims to improve pain, energy, mood, and overall function.

How does acupuncture work?

Acupuncture involves round-tipped needles that slide into the skin and do not cause bleeding. These needles are inserted and manipulated in specific regions for 15 to 30 minutes to direct or redirect Qi energy. Studies have reported that acupuncture stimulates the release of chemicals into the central nervous system that help to reduce pain.

Does acupuncture for occipital neuralgia work?

A review of 11 clinical studies investigated the effects of acupuncture on occipital neuralgia.

  • Nine studies compared participants treated with acupuncture only, versus those treated with medication or modified acupuncture method only.
  • Two studies compared participants treated with combined acupuncture and medication, versus those treated with the same medication or acupuncture only.

The pain rating scale, known as the Visual Analog Score (VAS), was used to measure treatment effectiveness and patient improvement. The studies commonly targeted specific acupuncture points located in the occipital region, known as ashi, GB 20 and EX-B2.

The review reported that treating patients with acupuncture for longer than two weeks may be most effective in treating occipital neuralgia. Patients who were treated with acupuncture experienced significant improvements compared to those treated with medication. The researchers could not definitively conclude that acupuncture was more effective because of the design of the clinical studies.

This review was the first to provide evidence of the effects of acupuncture for occipital neuralgia. According to the authors, “Although acupuncture only and combined acupuncture treatments showed significant effects compared to medication, the results of this study are inconclusive.”  Studies with better design and larger population sizes are needed to determine the effectiveness of acupuncture in occipital neuralgia.   

References:

  1. Yun, J., Lee, S., Cho, J. et al. The effects of acupuncture on occipital neuralgia: a systematic review and meta-analysis. BMC Complement Med Ther 20, 171 (2020). https://doi.org/10.1186/s12906-020-02955-y. Accessed August 16, 2020.
  2. Pilitsis, J. and Khazen, O. Occipital Neuralgia. American Association of Neurological Surgeries. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Occipital-Neuralgia. Accessed August 16, 2020.
  3. Acupuncture Canada. What is Acupuncture? https://www.acupuncturecanada.org/acupuncture-101/what-is-acupuncture/. Accessed August 16, 2020.

Image by Siew Ling Chow from Pixabay 

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