FAQs on Occipital Nerve Block Therapy

Occipital nerve block is the best available procedure to successfully overcome painful neuralgias and headaches. A safe and simple procedure, it numbs irritated nerves, reduces inflammation, obstructs pain signals to the brain, and mask the painful sensation.

What is Occipital Nerve Block?

Occipital nerve block refers to injecting numbing medication to neutralize pain sensation capacity of greater and lesser occipital nerves. Positioned just beneath the scalp on the backside of your head, these occipital nerves play an important role in “providing touch, pain, or temperature sensations to the back and top part of the head.” Disorder of these spinal nerves also leads to painful cervicogenic headaches and occipital neuralgia.

The procedure targets these spinal nerves. Anesthetic and corticosteroid medications are injected to numb these occipital nerves and inhibit their ability to carry pain sensation.

When Patients Require Occipital Nerve Block? What Conditions Are Treated Through Occipital Nerve Block?

Occipital nerve block injections are used for both diagnostic and therapeutic purposes. Men and women with following conditions are candidates for the therapy.

  • Occipital neuralgia: Often trauma, squeezing, or innervations of occipital nerves result in “pins and needles” sensation on either side of your head. It may accompany throbbing or burning pain, stabbing headache, and even visual disorders.
  • Migraine: A pulsating and recurrent intense headache caused by neurological disorder impacting the autonomous nervous system and worsens with physical activity.
  • Cluster headaches: A type of primary headache, it causes one-sided yet extreme pain in the head for a short duration following neurological disorders
  • Cervicogenic headache: Linked to neck anatomical disorders that compress roots of occipital and other spinal nerves. The pain starts in the neck and gradually spreads to the head. It is most commonly associated with neck arthritis.
  • Hemicrania continua headache: A chronic daily headache with continuous, fluctuating, or unilateral pain traced to inflammation, swelling, or soreness in nerves connecting the occipital area.
  • Other headache syndromes: Painful and persistent headaches traced to nerve irritation or tension in the head and neck areas can be controlled with numbing of these spinal nerves.

How Is Occipital Nerve Block Performed?

It takes a few minutes to perform an occipital nerve block. A tiny needle is inserted into the skin just below the scalp to administer medications around the occipital nerves. The outpatient surgery involves use of local anesthetic medicine prior to the injection to numb the skin and minimize the discomfort. The block targets both the occipital nerves.

What Is Injected During Occipital Nerve Block?

The occipital nerve block injections have anesthetic and corticosteroid medications. Many doctors also add steroid medications, such as with depo-medrol or celeston, so that patients have longer pain relief.

How Many Occipital Nerve Block Injections Should I Have?

If pain returns after a few months, you can repeat the occipital nerve block. It is natural for the medication effect to wear off with time. Many go for radiofrequency ablation after the injections to prolong the pain relief up to one year.

The repetition of occipital block injection varies according to the medical and health parameters of patients. When applied for occipital neuralgia diagnostic purposes, the reuse of the block injection depends on the improvement in patient’s conditions. For treatment, one can go for a series of injections (subject to doctors advice), if back-head pain symptoms subside and patient responds well after the initial procedure.

How Quickly Is Pain Relief Achieved With An Occipital Block?

Occipital block therapy provides pain relief as soon as the injection is administered. The numbing medication is found to be effective for many hours and continue pain relief from weeks to months.

Do I Need Rest After Occipital Nerve Block?

It is an outpatient procedure and patients are discharged within an hour. They even can drive home, but advised rest as the impact of the local anesthesia remains for a few hours. Neck soreness or pain may be there at the injection site, but it wears off in a day or two. Patients can join their daily activity and perform any task subject to their level of tolerance.

What Are The Side Effects of Occipital Nerve Block?

Temporary soreness, superficial pain, and skin irritation at the injection site are only side effects that the occipital nerve block procedure results in. These effects vanish within a day or two.

Doctors unmindful of individual nerve location and pathway differences are likely to cause injuries. Since the scalp receives huge amount of blood supply, lack of proficiency in the injection treatment for the area may result in bleeding. It can be contained with pressure bandage. Brief faintness may onset, if the medication amount exceeds the need.

The occipital block injection stays away from your skull preventing any risk of muscle weakness, brain disorder, or brain fluid leak. Those on blood thinners, with active infection, or allergic to anesthetics should report their conditions to doctors prior to the procedure.

How Well Does Occipital Nerve Block Work? What Are The Benefits of Occipital Nerve Block?

  • According to a 2006 study published in the Pain Practice journal, “the nerve stimulator-guided occipital nerve blockade significantly relieves cervicogenic headache and associated symptoms within two weeks following injection.” Another study found pain relief for 87% of patients over a period of six months.
  • The Journal of Pain suggested occipital nerve block as the best method to prevent painful cervicogenic headache and occipital neuralgia.
  • A 2011 report in the Journal of the Neurological Sciences also suggested the procedure for for migranre patients. It found “significant and rapid relief of headache, neck pain, photophobia and phonofobia within 4 weeks after injection.”

References

Scattoni L, Di Stani F, Villani V, Dugoni D, Mostardini C, Reale C, & Cerbo R. (2006). Great occipital nerve blockade for cluster headache in the emergency department: case report. J Headache Pain. 7(2):98-100.

Medvedeva LA. (2008). [Cervicogenic headaches: aspects of diagnosis and analgesia]. [Article in Russian]. Anesteziol Reanimatol. (5):96-9.

Repetitive occipital nerve blockade for cervicogenic headache: expanded case report of 47 adults. Naja ZM, El-Rajab M, Al-Tannir MA, Ziade FM, Tawfik OM. : Pain Pract. 2006 Dec;6(4):278-84

Occipital nerve blockade for cervicogenic headache: a double-blind randomized controlled clinical trial Naja ZM, El-Rajab M, Al-Tannir MA, Ziade FM, Tawfik OM. Pain Pract. 2006 Jun;6(2):89-95

Greater occipital nerve injection in primary headache syndromes–prolonged effects from a single injection Afridi SK, Shields KG, Bhola R, Goadsby PJ. Pain. 2006 May;122(1-2):126-9. Epub 2006 Mar 9

Ward JB. (2003). Greater occipital nerve block. Semin Neurol. 23(1):59-62.

Saracco MG, Valfrè W, Cavallini M, & Aguggia M. (2010). Greater occipital nerve block in chronic migraine. Neurol Sci. 31 Suppl 1:S179-80.

Vanelderen P, Lataster A, Levy R, Mekhail N, van Kleef M, & Van Zundert J. (2010). Occipital neuralgia. Pain Pract. 10(2):137-44.

Young WB. (2010). Blocking the greater occipital nerve: utility in headache management. Curr Pain Headache Rep. 14(5):404-8.