A man presented with right-sided cervical pain and radiation to the ipsilateral temporal region temporally associated with the initiation of his nocturnal continuous positive airway pressure (CPAP) mask, cureus.com reported. The 81-year-old patient experienced pain provoked by rightward axial rotation of the neck, reaching a severity score of 6 out of 10, which initially led clinicians to suspect severe cervical spondylotic disease due to his imaging results.
Cervical Spondylosis Versus Lesser Occipital Nerve Entrapment
Initial diagnostic reasoning focused on the patient’s advanced degenerative spine findings. However, clinicians eventually noted that the patient’s hyperalgesia was sharply confined to the lesser occipital nerve (LON) and C3 cutaneous territory rather than following a broader radicular pattern. The pain closely coincided with the start of his full-face nocturnal CPAP interface, secured by a four-point headgear whose lower straps encircled the occipital and upper nuchal region near the mastoid processes. The International Headache Society defines occipital neuralgia as tenderness and dysesthesia over the affected nerve, characterized by paroxysmal jabbing pain in the distribution of the third, lesser, or greater occipital nerves.
Ultrasound-Guided Nerve Block Treatment
To confirm the diagnosis, an ultrasound-guided anesthetic block of the right lesser occipital nerve was performed using a high-frequency linear probe over the posterior border of the sternocleidomastoid muscle at Erb’s point. Clinicians injected 4 mL of an equal-volume mixture of 2% lidocaine and 0.75% ropivacaine around the nerve under direct visualization. Immediately after the procedure, the patient reported complete resolution of his rotation-provoked pain, with his pain score dropping from 6 out of 10 to 0 out of 10.
Global Continuous Positive Airway Pressure Device Market Context
While individual patient cases highlight peripheral nerve interactions with medical equipment, the broader healthcare sector continues to expand its reliance on these respiratory devices. fortunebusinessinsights.com reported that the global continuous positive airway pressure masks market size reached USD 2.95 billion, with projections indicating growth from USD 3.15 billion to USD 5.26 billion by the end of the forecast period at a compound annual growth rate of 6.63%. North America dominated the regional share at 38%, driven by high diagnosis rates of obstructive sleep apnea and advanced homecare infrastructure.
Adults and Smart Devices Drive Global Market Trends
Market data indicates that adults represented roughly 82% of the market, while nasal masks made up about 28%. In 2025, Europe held 27% of the global market and Asia-Pacific held 25%, with Japan accounting for 7% of the Asia-Pacific share. Recent trends show a transition toward smart devices featuring Wi-Fi, Bluetooth, and mobile apps for remote monitoring of compliance.
CPAP Headgear Causes Occipital Neuralgia Symptoms
What caused the patient’s occipital neuralgia symptoms?
Clinicians attributed the pain to mechanical irritation and compression of the lesser occipital nerve caused by the lower straps of the patient’s nocturnal CPAP headgear crossing the nerve’s trajectory near the mastoid processes.
How was the lesser occipital nerve entrapment confirmed?
The diagnosis was confirmed pharmacologically through an ultrasound-guided anesthetic block using lidocaine and ropivacaine, which resulted in the immediate and complete resolution of the patient’s rotation-provoked pain.
What market size was reported for CPAP masks?
According to fortunebusinessinsights.com, the global continuous positive airway pressure masks market was valued at USD 2.95 billion, with North America holding a leading 38% share.
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