Headache & Occipital Neuralgia

Yes. Pain from the upper cervical spine, muscles, fascia, or surrounding nerves can refer into the back of the head, temple, forehead, or behind the eye. This is why evaluation should focus on the pain generator, not only the headache label.

Occipital neuralgia refers to irritation of nerves that travel from the upper neck into the back of the scalp. It may cause sharp, burning, aching, or electric pain that begins near the base of the skull and may radiate upward.

Trigeminal-mediated headache involves pain pathways that can affect the forehead, temple, eye, cheek, jaw, or face. These symptoms may overlap with migraine, sinus pain, dental pain, or nerve-related facial pain.

Normal imaging does not always show the structure producing pain. Nerves, joints, muscles, fascia, and dynamic mechanical problems may contribute to symptoms even when MRI findings are limited or inconclusive.

Ultrasound may be used to evaluate certain nerves, muscles, fascial planes, and soft tissue structures in real time. When appropriate, it can also help guide diagnostic or therapeutic procedures with precision.

They can be either. A carefully performed diagnostic block may help determine whether a specific nerve or structure is contributing to pain. In some cases, treatment may also provide symptom relief.

PRP or PRF may be considered when evaluation suggests a ligament, tendon, joint, fascial, or soft tissue pain generator that may benefit from a regenerative approach. It is not used as a generic headache treatment.

Ketamine may be considered for carefully selected patients with refractory headache, nerve pain, central sensitization, or complex pain patterns. It is considered only after a physician evaluation determines whether it fits the clinical picture.

Not always. Prior imaging is reviewed when available. Additional imaging may be recommended if the history, examination, or prior records suggest that more information is needed before treatment.

Please bring prior imaging reports, procedure records, medication history, and any notes from previous evaluations. The more clearly prior treatment can be reviewed, the better the next step can be planned.