I am new here and also have been diagnosed with occipital neuralgia. Mine comes from an injury that also resulted in muscle damage to my back. As for the Occipital Neuralgia, I have had therapy which helped very little. I have had a constant headache for 9 months. Actually 2 headaches. I also have a tension headache. I had an occipital nerve block done on both sides that provided relief for 2 weeks to the day. Then I had a radiopathy (sp?) done to cauterize the nerves. That worked for 6 weeks. Now my pain management dr has me starting topamax. I am concerned about the side effects. I also take fioreicet for the tension headache (with fair results), ibuprofen, darvon and flexeril. I also use a tens unit and lidocaine patches on my back. And I am still in pain. Above all I am concerned about the long term effects on my body. At 50 I still have a lot of years left in this body!