Cervical-occipital neuralgia / cervicogenic headache

I had similar issues, although I did the steroid shot. My situation is that the steroid shot did not help. So I was left with Gabapenten and other pain relief. Not saying you shouldn’t have the shot, as it has helped a friend, it just didn’t help me. The other thing that did help slightly was upping the dose of Gabapenten. Didn’t take pain away, but slightly improved. Good luck!

. 2 of my docs recommended amitriptyline (off-label), lowest dose, 10mg….for some reason this can help occipital neuralgia…in addition to some head/neck exercises.. …it helped me, and I can return to writing music arrangements and editing orchestral music, without pain—but I do have to do my work in a semi reclining position to avoid neck strain and work in short increments .

If it is truly a muscular headache, you could look into Botox injections. They are injected into muscle so no possibility of arachnoiditis

I’m a long-time sufferer from occipital neuralgia and my neurologist has tried Botox, steroids, Gabapentin, Celebrex, and ablations. I think the greatest relief comes from my NALU nerve stimulator. I take Tylenol, use ice packs and/or heating pad to get a few hours’ relief. I hope you have better luck!

Sorry for your pain and travails…as I wrote before, you might wish to check out amitriptyline, very low dose, 10mg….off-label, but docs are pretty much in agreement it can help .

Thank you all for your replies. This is a long process so far, with my doctor, a neurologist and finally a sports med doc who just referred me to PT. The sports med doc said there is a process before getting a shot due to insurance coverage. So, 3 months in and still suffering. Hoping the PT helps this week. Your replies give me hope and to know there are other treatments to explore will give me some discussion points with my doctor.

I agree with your comments. I had steroid shots and maybe helped for a few days. Also we might consider the long term side effects of steroids.

Gabapentin does help.

Sorry, but what's a NALU nerve stimulator?

I have Arachnoiditis following a treatment that had marginal benefit. A different diagnosis and treatment from yours. I think you are very right to be wary. It’s short term relief followed by a long term problem for which there is no real treatment.

Yes, the Sports Med doc put me on a 6 day regimen of steroids and it didn’t help one bit. LOL. HOWEVER, a deep tissue massage, which was pricey, but worth every penny, made me feel so good the next day. Two days later and I still feel good. Also, did two days of PT exercises.