How to diagnose occipital neuralgia?

Written by Zhang Hui
Neurology
Updated on September 03, 2024
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Occipital neuralgia is a very common condition, generally characterized by pain in the back of the head. The nature of the pain is usually dull, but it can radiate to the top of the head. To diagnose occipital neuralgia, the main examination is to see if there are any significant tender points along the course of the greater occipital nerve. If there are obvious tender points, it is likely that occipital neuralgia is a possibility. Additionally, there are some underlying causes of occipital neuralgia, such as cervical spondylosis, osteoarthritis, or inflammation of muscles in the head and neck area, and even some tumors. Therefore, it is necessary to perform comprehensive auxiliary examinations to rule out these related diseases, including MRI of the cervical spine and X-rays. Treatment is relatively simple and may include the administration of nerve-nourishing medications and pain relievers. (The use of medications should be under the guidance of a doctor.)

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Written by Na Hong Wei
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Symptoms of intercostal neuralgia

Intercostal neuralgia is essentially caused by inherent reasons, or pathological changes in the thoracic vertebrae, ribs, and pleura, leading to an inflammatory symptom involving the intercostal nerves. Therefore, the primary symptom of intercostal neuralgia is pain, but this pain has certain characteristics. First, the pain commonly occurs in the left second rib and the right second, third, and fourth ribs. Second, the range of the pain is usually semicircular; it does not extend beyond the anterior midline at the front or the posterior midline at the back, forming a semicircular pain along the ribs. Third, there are often fixed tender points, which sometimes are located in the costal cartilage or corresponding thoracic vertebrae and paraspinal area; these points, when pressed or tapped, can cause radiating pain. Fourth, many times the examination results are negative, so intercostal neuralgia tends to be a condition where the symptoms are severe, but physical examination often yields very few positive signs.

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How long does an intercostal neuralgia attack last?

Under normal circumstances, an episode of intercostal neuralgia usually requires about a week to improve. During this period, actively cooperating with treatment can lead to a quick recovery. Treatment typically involves orally administered non-steroidal anti-inflammatory and nerve-nourishing drugs, and it is necessary to reduce physical activity and minimize local irritation. It is crucial not to be exposed to the cold; local heat application is recommended. Commonly, a salt bag or toasted bran is used for heat application, which is quite sufficient. Applying heat twice a day, each time for more than half an hour, can enhance the effects significantly. Moreover, combining this with some physiotherapy methods, such as acupuncture, infrared therapy, and cupping, can yield very good results.

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Is intercostal neuralgia severe?

First, it should be noted that intercostal neuralgia is not a very serious disease; it is a chronic condition but can be recovered from with long-term treatment as long as treatment is consistently followed. Commonly, treatment for intercostal neuralgia can be supplemented with physiotherapy methods such as acupuncture, massage, and cupping, which are very effective. Additionally, topical application of ointments that invigorate the blood and dispel stasis, or oral administration of non-steroidal anti-inflammatory and neuro-nourishing medications, can be completely adequate. For cases where the symptoms of intercostal neuralgia are particularly severe, local block injections may be performed. Furthermore, it is important to rest and protect the affected area, avoid cold exposure, and minimize irritation to the area to facilitate recovery.

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Symptoms of tooth nerve pain

Symptoms of tooth nerve pain include pain triggered by cold, hot, sour, sweet stimuli, spontaneous pain, secondary pain, and nighttime pain, as well as unlocalized pain. These are also the main symptoms of pulpitis. Among them, pain triggered by cold, hot, sour, and sweet stimuli is more obvious. Sometimes the pain may intensify with temperature changes, such as cold and hot stimuli. If the pulpitis reaches the acute suppurative stage, there may also be pain that worsens with heat and is relieved by cold. It is common to see patients coming to the clinic holding cold water, indicating that cold water may provide temporary pain relief. In addition, severe nighttime pain might occur, where there is no pain during the day, but intense pain at night, sometimes making it difficult to sleep or waking from sleep due to the pain. Sometimes tooth nerve pain can also be unlocalized, potentially causing pain in the temporal area or affecting both upper and lower jaw teeth.

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How to relieve neuralgia

Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.