Common symptoms of occipital neuropathic pain are dizziness, nausea, heavy back of the head, migraine, dizziness, as if always unable to wake up, middle-aged, young and elderly can occur, such as in the upper edge of the sternocleidomastoid muscle or the posterior part of the mastoid (behind the ear) also has pain and tenderness, suggesting that the occipital nerve and the large auricular nerve are also sick. #清风计划 #
Figure 1: Techniques for examining tender spots in occipital neuralgia
The pathogenesis of occipital neuropathic pain can be summarized as follows: inflamed and swollen neck muscle strain "entrapment" of the occipital nerve. Working with your head down for a long time or playing with mobile phones and computers, "greasy" watching TV on the bed or sofa, etc., so that the muscles that maintain the physiological balance of the cervical spine, especially the small muscle groups under the occipital spine and the transverse process of the extra-occipital and cervical transverse process, the longest muscle of the head and the levator scapula, are easily subjected to traction injuries of abnormal forward bending stress, causing aseptic inflammation and swelling of the muscles, and forming tender points in the extra-occipital tube size and below (the inner and upper part of the Chinese medicine wind pool point), and the occipital nerve is the medial branch of the posterior branch of the cervical 2 nerve. Through these intramuscular segments, shallow out of the muscle aponeurosis, when the muscle strain is inflamed, inflammatory muscle spasms contract the entrapment nerve and produce clinical symptoms, turn the neck when the "jam" aggravates, so the patient does not dare to turn his head, the arrow in Figure 1 refers to the occipital nerve site, cervical 2 nerve innervation of the back of the head, half of the scalp and orbit, so the onset of occipital nerve pain often feels that there is a back of the head sinking, migraine, dizziness, total "sleep can not wake up" (Figure 2); the occipital nerve in the spinal canal, and the adjacent vertebral artery, Branches of the sympathetic nerve are accompanied when the occipital nerve is stuck in contraction caused by spasm of inflamed muscles. Can reflexively cause increased excitability of the cervical sympathetic nerves, increased release of catecholamines, stimulation of the basal artery of the vertebral arteries and internal carotid arteries, resulting in vasospasm, can cause temporary cerebral blood supply insufficiency, and dizziness occurs, when rotating the neck to cause increased nerve entrapment, can cause dizziness, spinning, and sometimes even fainting.
Figure 2, Radiation range of occipital neuralgia
diagnosis:
The diagnosis of this disease can be confirmed after the above clinical symptoms and the tender points slightly below the extraoccipital augmentation bone, the cervical spine X-ray results are no other obvious abnormalities, and other dizziness diseases are excluded.
treat:
Understanding the biomechanical principle of the onset of occipital neuralgia, it is easy to understand the relationship and sequence of prevention and "treatment of symptoms" and "cure", the patient to treat the disease of course, of course, first to relieve his symptoms, analgesia, remove the congestion factor in the occipital nerve walk, but remember that targeted exercise is the key to preventing and treating occipital neuralgia.
1. Eliminate inflammation and edema and relax spastic muscles and reduce symptoms
Futaline 25 mg orally 3 times a day, 15 minutes before meals, and carbamazepine 0.2 g in the evening, orally. Topically massage the rough bone bulge outside the pillow with futarin latex or wind oil essence, and after massage, the head and neck will immediately feel relaxed, and the eyes will appear "clear".
Occipital nerve tender points
2. Closed treatment for those with obvious pain
For example, 2% nufocaine or 2 ml of lidocaine plus 1 ml of compound betamethasone injection (debosone) is enclosed in the extra-occipital augmentation and the symptoms can be relieved immediately. The above treatments are all "palliative" measures for analgesia and dizziness, and they are still prone to recurrence.
3. Sports rehabilitation gymnastics
Patients should understand that the treatment of occipital neuropathic pain must also be combined with targeted exercises, gentle nodding and posterior head extension, and those with severe dizziness can rest their head and neck pillows on the back of the chair and do chest expansion exercises to drive the small muscles of the head and neck to contract exercises, which will help alleviate headaches and dizziness.
Concord fitness chair exercises
4. Change bad habits and often do fitness chair exercises
Remove the root cause of the biomechanical disorder of the disease, if the computer, mobile phone still play, the bow head, the bow back posture work is still the same, the disease will soon recur, remove the causative factors to change the bad living habits, change the bad work and leisure posture can be. However, many people require a bowed posture due to the nature of their work, which requires that in their spare time, they actively carry out targeted gymnastic exercises to enhance the head, neck and back muscles, increase the reserve of muscle strength and elastic retraction of the corresponding muscle groups, enhance the anti-fatigue ability of the entire neck and back muscle groups and long-lasting working ability and endurance, which is the fundamental prevention and control method - "cure the root cause". The design principle of gymnastics exercise is the opposite direction of the damage stress - reverse gymnastic exercise, which can enhance the neck muscles, improve the stability of the cervical spine, through neck gymnastics exercise, relax spastic muscles, activate blood circulation in the cervical spine area, eliminate edema, thereby alleviating symptoms; can enhance the neck muscles and their ability to tolerate fatigue, resist weather changes and damp and cold and other factors to stimulate the ability, thereby consolidating the therapeutic effect, preventing recurrent attacks. Regularly doing "Concord Fitness Chair Exercises" is a simple, feasible and effective prevention and treatment method.
5. Muscle electrical stimulation balance therapy for occipital neuralgia
The regular electrical stimulation treatment of the neck stretch muscles for 5 seconds is carried out with a contraction of 5 seconds, which is conducive to eliminating local edema of the muscles, loosening the spasmodic muscles, thereby alleviating symptoms; can enhance the strength of the neck muscles. It has a good adjuvant therapeutic effect. Trapezius muscles, the lower fibers of the levator scapula are attached to the inner upper angle of the scapula, both are often diseased at the same time, but also at the same time at this point slightly above the two muscles, place two electrode plates, the center distance of 7 to 8cm (if both sides are diseased, put on both sides), and then according to the electrical stimulation operation for treatment.
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