Occipital neuralgia is a headache disorder caused by irritation of the greater, lesser, and/or third occipital nerves, which results in paroxysms of pain in the posterior head. The most common cause is compression of the greater occipital nerve near its origin at the C2 nerve root or in the posterior neck. This compression may be secondary to myofascial entrapment from a muscle in the posterior neck, mechanical compression from a vessel or mass lesion, or a neck injury such as whiplash. Initially, the pain is often unilateral, but in one-third of cases it can be bilateral.

The incidence of occipital neuralgia is 3 per 100 000 individuals. While it can occur at any age, the average age at diagnosis is 40-70 years.

A positive response to occipital nerve blocks can be both diagnostic and therapeutic.