A Review of the Recent Findings in Minimally Invasive Treatment Options for the Management of Occipital Neuralgia
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REVIEW
A Review of the Recent Findings in Minimally Invasive Treatment Options for the Management of Occipital Neuralgia Ivan Urits . Ruben H. Schwartz . Parth Patel . Justin Zeien . Denton Connor . Jamal Hasoon . Amnon A. Berger . Hisham Kassem
. Laxmaiah Manchikanti . Alan D. Kaye .
Omar Viswanath Received: April 17, 2020 Ó The Author(s) 2020
ABSTRACT Occipital neuralgia (ON) is unilateral or bilateral neuralgia in the dermatomal nerve distribution of the greater, lesser or third occipital nerves and is a very common presentation of Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12340553. I. Urits (&) J. Hasoon A. A. Berger Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA e-mail: [email protected] R. H. Schwartz H. Kassem Department of Anesthesiology, Mount Sinai Medical Center, Miami, FL, USA P. Patel J. Zeien O. Viswanath Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA D. Connor O. Viswanath Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA L. Manchikanti Pain Management Centers of America, Paducah, KY, USA A. D. Kaye O. Viswanath Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA O. Viswanath Envision Physician Services, Phoenix, AZ, USA
neuropathic pain. ON, although common and well defined, is still a poorly understood pain syndrome. It often requires invasive treatment for long term and significant pain alleviation; however, the evidence supporting different options is still limited. Several minimally invasive techniques have proven to be efficacious and safe, and the selection depends mostly on response to nerve blocks, patient choice and provider preference. This is a comprehensive review of the latest and seminal literature available about occipital neuralgia and currently available minimally invasive treatment options. It covers the anatomical and physiologic biology at the base of neuralgia, the presentation and diagnostic process. It then reviews the available literature to provide description and comparison of the available methods for alleviation.
Keywords: GON; LON; Nerve Neuropathic pain; Occipital neuralgia
block;
Neurol Ther
Key Summary Points Occipital neuralgia, the most common neuropathic pain, is a common, well defined and poorly understood pain syndrome. It often requires invasive treatment for long-term and significant pain alleviation; however, the evidence supporting different options is still limited. Here we provide a summary of available methods with supporting evidence. Several minimally invasive techniques have proven to be efficacious and safe, and the selection depends mostly on response to nerve blocks, patient choice and provider preference.
INTRODUCTION Neuralgia is a sharp or stabbing pain that travels along the path of a nerve. A subtype of neuralgia is occipital neuralgi
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