🧠 Overview
Occipital headaches result from compression of the greater and lesser occipital nerves as they pass through the muscles at the back of the head. These nerves emerge from the upper neck and travel upward over the back of the skull. There might be a history of a car accident with whip-lash injury
🎯 Affected Nerve:
Greater, Third, and Lesser Occipital Nerves
The pain starts at the back of the head, where it meets the neck, and travels up and over the head towards the eye
Releasing the nerves at the back of the head
💭 Headache Characteristics
📍 Pain Location
Pain begins at the base of the skull, just above where the neck meets the head. It typically radiates upward over the back and top of the head, sometimes reaching the forehead or the area above the ear
⚡ Pain Character
Often described as a sharp, shooting, or electric shock-like pain. Many patients describe it as feeling like someone is driving a nail into the base of their skull.
🌊 Pain Migration Pattern
Starts at one or both sides of the occipital region (back of head) and travels upward like a band wrapping around the head. The pain may shoot forward over the top of the skull toward the eyes, or towards the area above the ears
✨ Pain Quality
Piercing, lancinating quality with sudden sharp jolts. Between attacks, there is often tenderness and a dull ache at the base of the skull. Patients are usually tender when touching the back of the head.
🔬 How we confirm it: the numbing test
We place a small injection of local anaesthetic at the back of the head, about three centimetres to the side of the midline where the nerve passes through the neck muscles. If the pain disappears within minutes, we have found your trigger.
💡 Important: We never recommend surgery without this test, your trust matters too much. If the numbing injection relieves your pain, surgery is very likely to help you. If it does not, we will tell you honestly and keep looking for answers with you.
⚕️ What the operation involves
Through small incisions hidden in the hairline at the back of the head, Dr. Sarhane gently frees the occipital nerves from the neck muscles and tight bands that squeeze them. The operation takes 60-75 minutes, under general or local anaesthesia as you prefer, and you go home the same day. Everything happens in the muscles under the skin, nothing goes inside the skull, nothing near the brain or the spine.
📊 What you can realistically expect
💊 Pain relief
Around 90-95% of patients improve significantly, the best results of any trigger zone. Most describe a 70-90% drop in how often and how badly their headaches come, and many stop their migraine medicines altogether.
💊 Fewer medicines
Over 85% of patients reduce medication use by more than 60%. Many patients become completely medication-free.
🏥 Getting back to your life
Light activities within 5-7 days. Some neck stiffness is common for the first 2-3 weeks and settles with gentle movement; we may suggest a few physiotherapy sessions to help. Full recovery is 6-8 weeks.
⏱️ What the first weeks usually look like:
- First few days: rest at home, simple painkillers if needed. Most people describe soreness rather than pain.
- First week: light activities and desk work for most trigger zones.
- Weeks 2-4: gradually back to exercise and your normal routine.
- Months 1-6: the nerve settles and your migraines improve step by step. Our nursing team stays in touch with you throughout, you are never on your own.