Occipital Trigger Zone

🧠 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.

💭 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.

⚡ 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.

✨ 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.

🔬 Diagnostic Nerve Block

Diagnostic nerve block involves injecting local anesthetic at the point where the nerves exit through the neck muscles, about 3 cm to the side of the midline at the base of the skull. Immediate relief confirms the diagnosis.

⚕️ Surgical Procedure

Surgery involves releasing the nerves from the trapezius and semispinalis muscles through small incisions hidden in the hairline. The procedure addresses both greater and lesser occipital nerves. Duration is typically 60-75 minutes.

📊 Expected Outcomes

💊 Pain Relief Results

90-95% of patients experience dramatic improvement. Most report 70-90% reduction in headache intensity and frequency. This zone has one of the highest success rates.

💊 Medication Reduction

Over 85% of patients reduce medication use by more than 60%. Many patients become completely medication-free.

🏥 Recovery & Postoperative Care

Return to light activities within 5-7 days. Some neck stiffness is common initially but resolves within 2-3 weeks. Full recovery takes 6-8 weeks. Physical therapy may be recommended to maintain neck flexibility.