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16831

Title

Chiropractic management of greater occipital neuralgia [case report]

URL

http://dx.doi.org/doi:10.1016/j.clch.2003.09.008

Journal

Clin Chiropr. 2003 Sep-Dec;6(3-4):120-128

Author(s)

Comley L

Subject(s)

Peer Review

Yes

Publication Type

Case Report

Abstract/Notes

Greater occipital neuralgia (GON) is the term used to describe signs and symptoms of irritation to the greater occipital nerve. Neuralgic pain is characteristically sharp and shooting in nature and distributed over the area of the nerve affected. In the case of GON, pain is typically located in the sub-occipital region and radiates superiorly to the posterior aspect of the skull. GON due to unilateral C1–2 degenerative joint disease (DJD) is a recognised clinical syndrome. Arthrosis of the C1–2 zygoapophyseal articulation can cause irritation of the C2 dorsal ramus due to their close approximation. The signs and symptoms of GON can vary widely between sufferers. The most common symptoms are unilateral sub-occipital pain accompanied by neuralgic pain travelling superiorly to the posterior aspect of the skull. Headache, dizziness, tinnitus, visual blurring and occular pain as well as other complaints can accompany this. The signs of GON as a result of C1–2 DJD are a decrease in cervical range of motion (particularly rotation); tenderness in the occipital region, particularly over the C1–2 articulation and exacerbation of pain with cervical spine motion. There is no uniformly effective treatment for this condition, once conservative treatment fails, surgery is the next option but there are many reported side effects and failed surgical cases. This case demonstrates how this syndrome was relieved in one patient by chiropractic management. The possible mechanisms by which manipulation can effect improvement in this condition are discussed.

This abstract is reproduced with the permission of the publisher; full text by subscription. Click on the above link for the journal record.

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