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  • Case Report
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Occipital neuralgia

Dental treatment can be a ‘headache'

British Dental Journal volume 236, page 186 (2024)Cite this article

A Correction to this article was published on 23 February 2024

This article has been updated

A 48-year-old female patient was seen in our outpatient clinic for constant pain in the back of her head and neck during the past one and a half months. With varying severity throughout the day, the pain was sharp and exacerbated by head/neck movements. On detailed questioning, the patient reported that the pain had started after multiple long visits to the dentist for tooth extractions lasting one month. Magnetic resonance imaging of the brain and cervical spine was normal. Past medical history was also noncontributory.

We report a case of occipital neuralgia following dental procedures where the management was guided by ultrasound. Many studies have clearly condemned dental work for fostering neck, back, and shoulder spasms for the dental practitioner.1 Yet, less commonly, some patients also have reported neck pain after going to the dentist. This is usually due to neck spasms that are caused by poor ergonomics, anxiety, and prolonged interventions.2 Similar to what we postulate happened in our case, one theory hypothesised that sustained contraction (spasm) of the posterior neck muscles may subsequently lead to irritation and/or inflammation of the GON.3 Three points of vulnerability for the compression of GON have been noted by Vital et al.4 ie around the obliquus capitis inferior muscle, through the semispinalis capitis muscle, and through the tendinous attachment of the trapezius muscle. In short, we recommend updated ergonomic dental chairs, staged dental treatment, and relaxation techniques for pain-free dentistry.

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Fig. 1

Change history

References

  1. Alexopoulos E C, Stathi I C, Charizani F. Prevalence of musculoskeletal disorders in dentists. BMC Musculoskeletal Disorder2004; doi: 10.1186/1471-2474-5-16.

  2. First L, Sein M. Acute cervical facet joint inflammation after a prolonged dental procedure: a case report. PMCR 2020: doi: 10.36076/pmcr.2020/4/153.

  3. Knox D L, Mustonen E. Greater occipital neuralgia: an ocular pain syndrome with multiple etiologies. Trans Am Acad Ophthalmol Otolaryngol 1975; 79: 513-519.

  4. Vital J M, Grenier F, Dautheribes M, Baspeyre H, Lavignoke B, Senegas J. An anatomic and dynamic study of the greater occipital nerve (n. of Arnold): applications to the treatment of Arnold's neuralgia. Surg Radiol Anat 1989; 11: 205-210.

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Authors and Affiliations

  1. Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey

    M. F. Aksakal, B. Kaymak, M. Kara & L. Özçakar

  2. Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey; Department of Physical Medicine and Rehabilitation, Mubarak Alkabeer Hospital, Kuwait

    A. J. Abdulsalam

Authors
  1. M. F. Aksakal
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  2. A. J. Abdulsalam
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  3. B. Kaymak
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  4. M. Kara
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  5. L. Özçakar
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Corresponding authors

Correspondence to M. F. Aksakal, A. J. Abdulsalam, B. Kaymak, M. Kara or L. Özçakar.

Additional information

The original online version of this article was revised.

When this Case Report was published, there were errors in the author list and author list order. The correct author list is below:

M. F. Aksakal, Ankara, Turkey; A. J. Abdulsalam, Ankara, Turkey and Jabriya, Kuwait; B. Kaymak, M. Kara, L. Özçakar, Ankara, Turkey

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Aksakal, M., Abdulsalam, A., Kaymak, B. et al. Dental treatment can be a ‘headache'. Br Dent J 236, 186 (2024). https://doi.org/10.1038/s41415-024-7059-7

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  • DOI: https://doi.org/10.1038/s41415-024-7059-7

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