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 Cheng Bin
Orthopedics
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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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Written by Cheng Bin
Orthopedics
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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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Written by Liu Yan Hao
Neurology
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How to treat occipital neuralgia?

Occipital neuralgia is caused by cervical compression of the greater occipital nerve, leading to neuropathic pain. Thus, treatment of occipital neuralgia may involve oral pain relief medications to temporarily alleviate symptoms. Additionally, some nerve-nourishing medications can be used in treatment. Fundamental treatment involves addressing cervical spondylosis, which can include cervical physiotherapy and the use of medications that improve blood circulation and remove blood stasis to treat cervical spondylosis. It is also important to take care of the cervical spine by not sitting for too long; if sitting for extended periods, one should get up and move to stretch the muscles and bones. Performing the "little bird flying" exercise, where the head is leaned back and both arms are extended backwards, can effectively relieve cervical spondylosis and the pain caused by cervical compression of the greater occipital nerve. Additionally, the pillow should not be too high when sleeping at night.

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Written by Na Hong Wei
Orthopedics
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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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Written by Cheng Bin
Orthopedics
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Is it sciatica?

It should be noted that the incidence of sciatic nerve pain is still very high in clinical settings, and there are many causes which can lead to severe pain when it occurs. Common causes of sciatic nerve pain include conditions like sciatic neuritis, which can result in patient discomfort, as well as lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar tumors. Compression of the spinal nerves can also lead to sciatic nerve pain. Additionally, piriformis syndrome can cause sciatic nerve pain in patients. Determining the specific cause requires a physical examination along with some auxiliary tests to make a clear diagnosis, after which active symptomatic treatment can be completely effective.