Arthritis nerve pain in head

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Pain caused by injury or irritation of nerves in the neck from arthritis can lead to pain in the head.

Osteoarthritis of the neck, also known as cervical spondylosis, is a degenerative process that affects the cervical spine.

Cervical spondylosis is a condition that mainly affects older people, usually over 40. The degenerative changes can lead to nerve root irritation.This can then cause nerve compression or inflammation.

Symptoms depend on the location of the nerve compression, but can include pain, numbness, weakness, headaches, urinary problems, etc.

Others will have neck or shoulder pain, headaches in the back of the head, or stiffness of the neck. They may have difficulty turning or bending the neck from side-to-side.

Pain the occiput, back of the head, is due to nerve root irritation coming from the upper part of the cervial spine. The radiates up the back of the head, usually on one side more than the other, and can also radiate to the temples. Patients may complain of visual changes. They may also experience migraine-like headaches.

The symptoms may get worse with turning, extending, or bending the neck.

Examination of the neck and head may show significant tenderness at the base of the skull following the course of the greater occipital nerve. This is called occipital neuralgia.

Imaging studies such as CT scanning or MRI may be helpful in making or confirming a diagnosis, and in excluding other causes of pain in the back of the head such as tumors.

Nerve conduction studies and electromyography is less useful.

A soft cervical collar and physical therapy are a good starting point. A neck support pillow may help with sleep. Sometimes, nerve blocks, injections of local anesthetics and glucocorticoid may help relieve symptoms. This is particularly true in the case of greater occipital neuralgia.

Cervical epidural blocks may also be effective for alleviating pain. More recently, there has been interest in the use of botulinum toxin (Botox) to help with this condition.

If that does not work, then surgery to decompress the nerve and stabilize the neck may be necessary.

Surgery is usually done if:

Conservative measures do not work.

There are significant neurological deficits indicating cord compression.

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