Caffeine and Occipital Neuralgia

Caffeine is the #1 approved drug of many societies, found in tea, coffee and energetic drinks. Caffeine boosts energy levels, releases dopamine and stabilizes mood, which makes it a highly psychoactive substance. Occipital neuralgia, a condition of debilitating nerve pain at the back of the head, arises from irritation to the occipital branch of the trigeminal nerve. Therefore, can caffeine impact occipital neuralgia?
Klara Hatinova

Klara Hatinova

Klara is postgraduate researcher in experimental psychology at the
University of Oxford.

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What is Occipital Neuralgia?

Occipital neuralgia is a chronic headache disorder that originates from the occipital region, the back of the head and spreads through the occipital nerves. The occipital nerve is a critical nerve leading from the base of the neck along the back of your head [1].

Occipital neuralgia pain can be sharp, piercing, or stabbing, caused by damage or inflammation to the occipital nerve [2]. It is diagnosed by the location, duration, and intensity of the pain and by the fact that it is unilateral—meaning only on one side of the head [2]. Further neuroimaging may be involved to rule out other causes of pain.

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The common causes of occipital neuralgia include pinched nerves in the neck, tight neck muscles, head or neck injuries, chronic neck tension, osteoarthritis of the upper cervical spine, tumors affecting nerve roots, blood vessel inflammation, gout, and infection. Other less common causes include diabetes, neoplasms, fibrositis, myositis, fractures, compression of nerve roots, and certain structural abnormalities. [1] [2] [3] [4]

Occipital neuralgia can be treated using various methods. Initially, home treatments such as applying warm compresses and taking NSAIDs like ibuprofen may be recommended. Physical therapy, muscle relaxers, and massage can help with pinched nerves caused by tight muscles. Medications like antiepileptics and tricyclic antidepressants can be used to reduce symptoms. If conservative methods don't work, a local anesthetic can be injected into the occipital area for immediate relief. In some cases, surgery may be recommended to relieve nerve compression. [1] [2]

Occipital neuralgia is a rare type of chronic headache disorder. It's estimated that occipital neuralgia affects about three out of every 100,000 people every year [1,2,3].

What is Caffeine?

Caffeine is the most frequently used stimulant, similar in effects to Tesla pills discussed in a previous blog. It is an alkaloid, a secondary plant metabolite consumed daily in beverages like coffee, tea, and chocolate, as well as in some medications or energy drinks [4]. Caffeine is also used to increase lipolysis and diuresis, increase fat breakdown, and reduce water retention [5]. Caffeine can also be used to enhance sports performance.

How Does Caffeine Work in the Nervous System?

Caffeine interacts with multiple central nervous system receptors and neurotransmitters. It is a non-selective adenosine receptor antagonist. This means it blocks the action of adenosine, a neurotransmitter that predominantly promotes sleep and relaxation [6]. By blocking adenosine receptors, caffeine increases energy metabolism throughout the brain and activates noradrenaline neurons, which can increase the release of dopamine and serotonin [6]. This is why coffee makes people happy.

  • Caffeine also interacts with the cholinergic system, although the exact nature of this interaction is not fully understood [7]. The cholinergic system is essential for cognitive function and is implicated in Frontotemporal Dementia and Alzheimer’s Disease.
  • Caffeine modulates the activity of other synaptic receptors and channels via mobilization of intracellular calcium, inhibition of phosphodiesterase, and antagonism of adenosine receptors and GABA receptors [8].
  • Caffeine can improve exercise performance when ingested at moderate doses by reducing fatigue, increasing heart rate and improving blood circulation [9].

In summary, caffeine is a potent stimulant with broad effects on the nervous system, capable of modulating neural activity and neurotransmission.

Caffeine and Occipital Neuralgia

Occipital neuralgia is a specific headache in the back of the head and upper neck, typically localized to one side. It is challenging to manage, usually requiring medications, physical therapy, and, in some cases, surgery [10, 2].

Caffeine acts on adenosine receptors throughout the body. However, the role of adenosine receptors differs between the central and peripheral nervous systems.

Below, I will discuss the effects of caffeine on occipital neuralgia and pain:

  • Caffeine has been shown to enhance the efficacy of certain analgesic drugs, such as ibuprofen and acetaminophen. Indeed, acetaminophen and caffeine are the standard treatment for occipital neuralgia [11].
  • In fibromyalgia, a headache condition similar to occipital neuralgia, caffeine reduced pain and enhanced the analgesic properties of opioids [12].
  • Caffeine alone did not affect trigeminal pain processing, demonstrating the multifaceted impact of caffeine on different types of pain [13].
  • Caffeine overdose and caffeine withdrawal can increase the risks of headaches, such as occipital neuralgia [14].
  • In a rat model of neuropathic pain, caffeine diminished the analgesic effects of amitriptyline, a medication sometimes used to manage occipital neuralgia [15].

Summary: Caffeine and Occipital Neuralgia

Caffeine is a stimulant commonly used in occipital neuralgia to enhance the effects of medications, such as acetaminophen. This analgesic potentiation effect is likely due to adenosine’s role in pain. Despite this, caffeine alone is likely not effective for reducing occipital neuralgia, and caffeine overdose or withdrawal can exacerbate headache conditions.

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Klara Hatinova

Klara Hatinova

Klara is a postgraduate researcher in experimental psychology at the University of Oxford. She has worked across a spectrum of hot topics in neuroscience, including her current project measuring reinforcement learning strategies in Parkinson’s disease. Previously, she studied the efficacy of psilocybin as a therapy for critical mental health conditions and examined molecular circadian rhythms of migraine disorders. She completed her undergraduate degree in Neuroscience at the University of Glasgow and participated in a year abroad at the University of California, where she worked on a clinical trial for spinal cord injury.