are you suffering from intense sharp pain at the back of your neck
radiating to your forehead or at one side of your neck or
shoulder hi my name is annie and welcome to my channel annie pilatus physical therapist
i'll be demonstrating some simple treatment plans for occipital neuralgia which is an injury at the
base of your skull area on your c1 or c2 level that creates this inflammation of chronic pain and
weakness so get your mat ready and the pillowcase or a scarf to join me today
so let's discuss a little bit about occipital neuralgia so occipital neuralgia is an injury
at the base of your skull where your spinal cord going all the way up it's a starting point where
it attaches before it goes to your brain area so c1 c2 level is the highest of your surgical
spine and it's also the part of the spine it's very important to hold your head and there's
nerves coming out at that c1 c2 level that helps radiates sensation to the skull
area base of your neck that creates tension headaches as well as difficulty turning your neck
usually on the side of injury but if it's becoming so chronic it can be tight and stiff on both sides
and the muscles that supports the neck are the scalenes vator scapulae suboccipital muscles
so these muscles needs to be strong postural muscles have that injury it creates this weakness
usually in one side you have shoulder injury it also creates this tension of weakness that
pulls your neck down to one side so no matter how much you stretch if you don't stabilize your neck
and strengthen then this nerves that comes out of the c1c2 level gets re-inflamed and you have this
chronic cycle of never-ending pain so what are the symptoms of occipital neuralgia this release
pain at the base of the scalp the neck area sensitivity to light stabbing pain behind your eye
tenderness on your scalp and difficulty moving your neck so what are the causes of occipital
neuralgia number one reason could be a whiplash trauma on your neck area someone gave you a bad
blow behind your head if you have osteoarthritis tight neck because of poor posture if you have
tumors near your neck diabetes and other factors that create this tension around the base of your
head so how can you diagnose if you have occipital neuralgia it is best to see your doctor still or
your local physical therapist and they will do special tests to check where the pain is
coming from having diagnostic imaging such as mri will help us understand more if you have any disc
inflammation creates this narrowing of the canal of your foramen where the nurse comes out so my
recommendation please see your doctor or your physical therapist before you start any treatment
it is also best when you speak to your doctor that they will recommend some muscle relaxants
anti-inflammatory drugs and pain medications so it will help you sleep well and if you're
sleeping well guess what you are healing so want to make sure you combine all of these factors
because it's really painful having this symptom it could take you months or years if you don't
treat it properly so in this video i will show you how to do step-by-step guide on how i can
fix my patients who had occipital neuralgia for many months and finally found relief utilizing my
techniques of pilates yoga and physical therapy control movement patterns that's perfect for
you finding the sweet spot that works best for you so most of my patients doing back extension
with the gentle rotation when you feel there's less sharp pain it's the best movement for my
patients so it's important to do some assessment first so if you find out you have injury on your
left side and you have more pain going down on one side it is best to check which movement pattern
creates pain if there's more pain stopped means you have to limit that movement you have to find
centralization of pain which means if the pain goes down further the shoulder or goes
more towards your forehead or the scalp area then you are making it worse example if i'm
turning my head to the right and my injuries on the left and i feel like it's a regular pain but
just pinching pain in the area without radiating going down the shoulder then that's safe
and then when i turn to the left just gently and i feel like sharpening going down on that side then
stop you have to continue away from the pain and once you feel a little bit better you can always
test it again after a few days then test the limit core stretching is important myofascial release as
well as placing some heat on your neck for at least 20 minutes before you do your exercises
at the same time before someone massages your neck you can also do some simple neck stretches and
snag techniques so snack is a lovely way to help pull your neck almost yourself manual traction
that you can use you can do utilizing a scarf or a pillowcase so you can get the pillow again with
the exercises let's start with snag techniques so at the base of the skull you can use the edge
of your pillowcase so i'm using this side and i'm gonna gently pressure at the base of my skull
near your ear area you're pressing a little bit on your ear to pull it further in the middle
as you slowly look up for extension as i look up i breathe in and as i let go exhale hold
that five seconds hold ten times so that's one torus extension and now we're gonna do rotation
gently extend and slowly turn to one side so if your painful side is in your left turn away first
towards the right i'm pulling it towards my jaw area slight rotation with the tilt
with a gentle extension and hold that as well five seconds hold ten times now let's
face the painful side towards the left where you have the most limited motion
so snag extension first then now my right hand towards the left i'm going to pull it towards
my face my cheek and jaw with a gentle tilt and once you feel the range at the end range hold that
five seconds hold ten times and after doing both ways and extension now it's best to do
a little bit side bending so if your painful side is your left you're going to place the pillowcase
on your shoulder one hand at the back and one in the front so you want to make sure you're
gonna pull tension downward so i'm gonna pull it down hold it there for five seconds hold and then
gently tilt away to feel that scalene stretch and you feel that all the way down to your shoulder
five seconds hold ten times and after doing this bad side it's best to check the opposite
side as well so one hand in the front a little bit internal rotation the back hand gently
pull it down and make sure it's on the top of your shoulder near your clavicle
and you're gonna feel the end of this neck area where you're gonna pull some tension
as you pull it down for five seconds hold and then gently tilt away side bend five seconds
hold ten times so after those gentle stretches it is best with occipital neuralgia to stabilize
your neck so isometrics is so important so with neck symmetrics you're gonna use your hand first
start on the good side as you gently press towards the temporal area of your skull
keeping your head neutral you can do it in the front of the mirror so you can see your posture
hold that for five seconds hold ten times if five seconds hold this creating pain you can
start one to two seconds and then slowly progress five seconds then do the other side five four
three two one ten times and you feel one side a little bit much more difficult
and weaker and that's fine so you'll know how to catch up on the good side
now is flexion on your forehead keeping your head straight hold it for five four three two
one i'm using my right hand if your weaker side is your left then use your stronger arm
so you're not straightening your neck now class your fingers place it behind your head and gently
press forward keeping your head straight for your neck extensors hold that for five seconds hold
and now with a little bit dynamic movement a little bit a little bit 45 degree angle not full
rotation just diagonal and then pressure again at the temporal area and hold it five
five seconds hold ten times and turn towards the injured side five seconds hold ten times
and once the isometrics gets easier then you can utilize elastic band wraps around your head with
different resistance as you get stronger and after doing those isometrics then we can do some yoga
hands and knees position hands level to your shoulders knees towards your hips cat and
camel is my favorite as you round inhale acid exhale slowly lower your chest and then fully
extend looking up again inhale looking down chin tuck belly button in engage your core muscles
and exhale looking up and my recommendation is at eight times only strengthening your core improving
your posture is best if you have occipital neuralgia no matter how much we fix the neck
if your core and glutes and the rest of your body is tight
it will definitely not help your recovery if you don't start doing other movement patterns
after doing cat and camel then you can do thread the needle by doing beginners only just
twisting one side and then down so i'm not lifting my arm yet for beginners again just twisting
and down and do that five seconds hold ten times the last exercise is child pose lowering your
hips extending your arms forward and hold that 30 seconds hold three times with your deep breathing
and you can progress by doing poppy pose by extending your hand at the edge of the mat
lowering your chest down keeping your hips up and lowering your chest hold that for 10 seconds hold
for beginners to progress to 30 seconds and making sure your forehead is resting on the mat
do that three times and this is only demonstration only if you want to follow along video leave a
comment down below direct message me my social media description link down below and try my
best to answer each one of you and i have more variety of exercises you can do for your neck
here's the link for your neck this progression utilizing elastic band that you can find out and
more yoga poses as your gentle progress if you love this video if you find value about pilates
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