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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Occipital Neuralgia

I have many health conditions. One being Occipital Neuralgia. It started out, many years ago as just on the Right Greater Occipital nerve. It has spread to several places within my head. I have been treated with several different medications. One was Nardil. That just made me pass out. I ve had injections at the site and the latest ones being in my neck, where it meets the head. Those shots made me have even worse headaches. I also have Cluster headaches. I do not think my Occipital headaches are among my Cluster headaches. Can you help me figure out what else I can do about these headaches. Most of the time they are just burning aching headaches. Often times they feel like a volcano has erupted and hot lava is flowing over that site. As I mentioned, I do have several other medical conditions, a few of which are, Peripheral Neuralgia mostly on the balls of my feet. Burns like crazy. I also have Spinal Stenosis which affects mainly my right hip. to the extent of not being able to walk much. I also have Fibromyalgia. Please let me know if you can give me any anwers or information you might know of Sincerely, Carol Ann McCarn
Sun, 4 Nov 2018
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General Surgeon 's  Response
Hi,

Regarding the treatment of occipital neuralgia, there are several options. Usually, pharmacological treatment is tried first and if that fails or the drug is not well tolerated local nerve block (injection) is tried and lastly if nothing works surgery.

Lyrica is one of the first line drugs so I think it was correct to try it first. Since you say it isn't working perhaps it is time for the injection. However, 100 mg a day you have been taking is a low dose, so to be convinced it's not working you could try augmenting the dose first, at least 150 mg a day (50 mg three times a day), can go to 300 mg a day maximum (that is if you don't have kidney impairment or some other contraindication or adverse effect.)

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ivan R. Rommstein,
General Surgeon
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Suggest Treatment For Occipital Neuralgia

Hi, Regarding the treatment of occipital neuralgia, there are several options. Usually, pharmacological treatment is tried first and if that fails or the drug is not well tolerated local nerve block (injection) is tried and lastly if nothing works surgery. Lyrica is one of the first line drugs so I think it was correct to try it first. Since you say it isn t working perhaps it is time for the injection. However, 100 mg a day you have been taking is a low dose, so to be convinced it s not working you could try augmenting the dose first, at least 150 mg a day (50 mg three times a day), can go to 300 mg a day maximum (that is if you don t have kidney impairment or some other contraindication or adverse effect.) Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein, General Surgeon