Occipital Nerve Block

Chronic headaches have become very prevalent. Estimates suggest that up to 5% of the global population is affected by this type of pain. Examples of this condition include:

  • Chronic migraine
  • Episodic migraine
  • Chronic cluster headaches
  • Episodic cluster headaches
  • Tension-type headaches
  • Occipital neuralgia

Occipital neuralgia is a condition associated with damage or dysfunction of the occipital nerves. The symptoms of this condition may include a dull, throbbing pain mainly confined to the back of the skull or top of the neck.

An occipital nerve block inhibits or blocks the disproportionate or chronic signals that are sent to the brain, processed and perceived as headache pain. Occipital nerve blocks may result in pain relief lasting up to several months, depending on the response of the individual patient to this treatment.

What is an occipital nerve block?

An occipital nerve block is an injection of a steroid or other medication around the greater and lesser occipital nerves that are located on the back of the head just above the neck area.

What is the purpose of an occipital nerve block?

The steroid injected reduces the inflammation and swelling of tissue around the occipital nerves. This may in turn reduce pain, and other symptoms caused by inflammation or irritation of the nerves and surrounding structures. Typically, headaches over the back of the head, including certain types of tension headaches and migraine headaches, may respond to occipital nerve blocks.

How long does the occipital nerve block take?

The actual injection takes only a few minutes.

What is actually injected?

The injection consists of a local anesthetic and a steroid medication.

What should I expect after the occipital nerve block?

Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last only for a few hours. Your pain may return and you may have a sore head for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself. You should start noticing a more lasting pain relief starting the third day or so.

Can I go to work to work the next day?

Unless there are complications, you should be able to return to work the next day. The most common thing you may feel is a sore head at the injection site.

How long does the effect of the medication last?

The immediate effect is usually from the local anesthetic injected. This wears off in a few hours. The steroid starts working in about 3 to 5 days and its effect can last for several days to a few months.

How many occipital nerve blocks do I need to have?

It varies. The injections are done about one week apart only if needed. If the first injection does not relieve your symptoms in about a week to two weeks, you may be recommended to have a second injection. If you respond to the injections, you may be recommended for additional injections when the symptoms return.

Can I have as many occipital nerve blocks as I need?

With some exceptions, in any given six-month period, we generally do not like to perform more than three occipital nerve blocks. This is because giving more injections could increase the likelihood of side effects from the steroids that are injected. Likewise, if the patient needs more frequent injections, other treatments should probably be considered.

Will the occipital nerve blocks help me?

It is difficult to predict if the injection will help you or not. Generally speaking, patients who have recent onset of pain may respond much better than the ones with a longstanding pain. Usually the first injection is as much a test as a treatment. The first block will confirm that the occipital nerves are involved in the pain and be helpful. Or it will not help and the occipital nerves will not be suspected as part of the pain.

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