Occipital neuralgia is a condition involving irritation of the occipital nerves and is often
characterized by sharp, shooting, burning, or electric-like pain that starts near the base of the skull
and radiates upward. A 2025 study of 212 patients with occipital neuralgia found that 117 reported a
prior head or neck injury, with whiplash identified as the most common cause. Let’s look at how a
history of whiplash may influence the risk of occipital neuralgia.
The greater occipital nerve originates from the second cervical spinal nerve and passes
through several layers of muscle and connective tissue before reaching the scalp. During a whiplash
injury, the rapid back-and-forth motion of the head and neck may stretch or compress the nerve,
cause microscopic injury, or trigger abnormal nerve signaling. In some individuals, these changes
may contribute to the shooting, burning, or electric-like sensations.
Whiplash commonly causes tightness in the small muscles at the base of the skull as well as
tension throughout the neck and shoulders. When these muscles remain chronically tight, they may
place pressure on nearby occipital nerves and contribute to symptoms. Trauma can also affect the
joints between the skull and first cervical vertebra as well as those between the first and second
cervical vertebrae. These structures are closely related to the nerve roots that eventually form the
occipital nerves. Joint irritation may increase local inflammation, alter nerve mechanics, and produce
pain patterns that resemble occipital neuralgia.
The healing process itself may also play a role. As injured tissues repair, scar tissue and
thickened connective tissue can develop. Because the occipital nerves pass through multiple
muscular and fascial layers, these changes may reduce the available space around the nerves and
contribute to ongoing irritation or entrapment. In some individuals, the nervous system becomes
more sensitive following injury. This process can cause normally harmless sensations to become
painful and may contribute to scalp tenderness, increased nerve sensitivity, or symptoms that persist
long after the initial injury has healed.
Occipital neuralgia is sometimes mistaken for migraines, tension headaches, or headaches
that originate from the neck. Clues that suggest occipital neuralgia include pain that begins near the
base of the skull, tenderness over the occipital nerves, scalp sensitivity, and sharp pain that radiates
toward the top of the head. Because several conditions can produce similar symptoms, a thorough
examination is important. If the examination suggests occipital neuralgia is present and the patient is
a candidate for chiropractic care, treatment may include a multimodal approach using manual
therapies, specific exercises, physiotherapy modalities, and patient education to help reduce
mechanical stress on the occipital nerves. Chiropractors are also trained to recognize when comanagement or referral to another healthcare provider may be appropriate.
Brent Binder, D.C.
4909 Louise Dr. Suite 102
Mechanicsburg, PA 17055
Pain Relief Chiropractic 
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