Occipital Neuralgia

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Anatomy

• Pathway
  • Leaves the spinal column through the arch of the atlas and the axis
  • Travels toward the area of C2/3 facet joint inferolaterally and then curves around the inferior oblique capitis mm to ascend toward the occiput deep to the semispinalis capitis mm
  • Pierces either the tendon of the trap or between then trap and semispinalis to reach the occipital area
• Formed by posterior division of CN II
• Greater occipital nerve is the largest purely afferent nerve in the body

Innervation

Innervates the post skull from suboccipital area to the vertex

Associated pathologies

• Cervicogenic headache

Dysfunction

During a violent forced extension, the posterior arch of the atlas (C1) can be caught between the occipital bone and the posterior arch of the axis (C2) resulting in a “nutcracker” mechanism which fractures the atlas¹.

References

1.

Jones B. B Project Foundations. b Project; 2025.