A couple of weeks ago, we talked about the definition of a migraine, which in many practical instances is simply a name given to a constellation of symptoms. We also spoke about occipital (meaning back of the head) and neuralgia (meaning nerve pain). When all is said and done, however, the real question is: “Can you figure out which ‘neur’ (i.e. nerve) is causing the ‘algia’ (i.e. pain)?” Is occipital neuralgia therefore considered a headache?
Well, yes and no. occipital neuralgia can give you symptoms of a headache because it can cause head pain and any head pain is by definition a “head ache”. Can occipital neuralgia fall under the definition of or be considered a migraine? The answer to that question is also technically, “yes”’ because all the clinician and patient will “see” is the presence or complaints of head pain that is this level of severity, this frequent (often constant), associated with these other sensations (e.g. pulsation/throbbing, light sensitivity, nausea) and this duration (usually several hours or more at least). These characteristics are now established, but say nothing about the cause of the headaches. Is it a chemical imbalance, an issue of an inflamed blood vessel or a compressed nerve?
The upshot is that so many of the patients who come to see me have been diagnosed with migraines which is not necessarily inaccurate, it’s just not very specific. Many people who have been diagnosed with migraines do find a conventional treatment modality that works for them (e.g. medication).
However, there are also many millions who don’t have success with these traditional modalities and the reason is because the diagnosis of “migraine” doesn’t tell you what’s causing the problem and therefore how to fix it. Those people end up being treated “empirically”; in other words, it’s like throwing darts at a dartboard - try this drug, or that drug or these drugs together or these drugs with massage, PT, acupuncture, etc. to see if you can find something that works.
What practitioners are really trying to do is figure out what problem - chemical imbalance, muscle tightness etc - is causing the issue by eliminating factors one by one using trial and error. At its essence, actual occipital neuralgia is the result of pressure on a peripheral nerve(s) in the occipital region. If you can figure out which nerve(s) is involved, in many cases, the headaches can be significantly improved or completely relieved by surgical intervention.
To learn more about Occipital Migraines or schedule a consult with Ziv M. Peled, M.D. visit www.peledmigrainesurgery.com today.