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Occipital Nerve Block

Last reviewed by Editorial Team on August 13th, 2018.

The occipital nerve block is a medical procedure in which medication is injected into one of the occipital nerves (greater or lesser), with the purpose of blocking the pain signals transmitted to the brain. This procedure is generally recommended in patients who are suffering from chronic headaches, as a result of occipital neuralgia. This procedure is not indicated for all patients who are suffering from chronic headaches but, in selected cases, it can provide superior relief from the pain, in comparison to the other treatment alternatives (such as the oral medication).


What does the occipital nerve block do?

The occipital nerve block works to reduce the inflammation of the tissues that are located around the occipital nerves. At the same time, the pain signals that are normally transmitted to the brain are blocked, which means that the patient will benefit from significant pain relief. The pain relief can appear almost immediately after the procedure and, depending on the patient, it can last from a couple of weeks to several months.

Benefits

These are the benefits of the occipital nerve block:

  • Significant pain relief
  • Reduction of inflammation in the tissues around the occipital nerves
  • Reduction of discomfort and throbbing sensation associated with chronic headaches
  • Suppression of migraines
  • Elimination or reduction in intensity of other associated symptoms of occipital neuralgia, such as:
    • Ringing in the ear (tinnitus)
    • Paresthesia at the level of the scalp
    • Nausea
    • Vertigo
    • Blurry vision
  • Reduction of the intensity, frequency and duration of cluster headaches
  • Reduction in intensity of other symptoms of cervicogenic headaches, such as:
    • Nausea
    • Vomiting
    • Sensitivity to light and sound
    • Loss of appetite.

Procedure

The doctor will use a small needle in order to inject a local anesthetic in combination with anti-inflammatory medication (commonly used – corticosteroids). The injection can take several minutes and you might feel discomfort or even a little bit of pain. The injected is made with the patient seated or lying down. Before injecting the above-mentioned substances, the doctor will clean the respective areas with antiseptic solutions.

What to expect after the occipital nerve block?

Immediately after the occipital nerve block, you might feel a slight discomfort or pain at the site of the injection. Some patients report a sensation of warmth, which goes away in a couple of hours. During the next couple of days, you may experience soreness at the site of the injection. However, after the third day, you will notice a significant pain relief from the headaches you used to experience.

Risks

In general, this is a procedure that is relatively safe, with few risks. One of the risks that this procedure presents is infection, provided no antiseptic substances have been used to keep the area clean or the procedure was not made in a sterile environment. Other risks relate to the possibility of hemorrhage or to the aggravation of the symptoms (in condition of misapplication). However, you must remember that these risks are quite rare.

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Side effects

In terms of side-effects, these can include the temporary pain that occurs during the first few days after the procedure and the numbness that is temporary as well. Only in rare cases, one can suffer adverse reactions from the anesthetic or corticosteroids injected. Emergency medical treatment will be necessary, in order to prevent the risk of vascular collapse. Some patients might lose their area in the area where the injection was made but this is only temporary. There are no other side-effects associated with the occipital nerve block.

How often can you get the occipital nerve block?

The frequency of the occipital nerve blocks depends from one person to the other. However, in general, the injections are made one week apart. The doctor will perform the first injection and wait for the symptoms to improve. If the patient does not obtain significant pain relief from the first injection, the doctor will recommend the second injection within one or two weeks. Additional injections are going to be recommended only with the return of the symptoms.

On average, it is indicated that you do not have more than three occipital nerve blocks within a period of six months. This is mainly related to the fact that the medication injected is represented by corticosteroids, which can have negative effects over a person’s health if injected too often or in higher quantities. It is probable that the doctor will consider other treatments, instead of administering the occipital nerve blocks more frequently than they should be administered. In deciding on the frequency of the occipital nerve blocks, the doctor will weigh in the benefits, in comparison to the risks.

How long does it last?

It is important to understand that the duration of the procedure depends from one patient to the other and also on the condition the person is suffering from. In general, the relief from the pain is obtained shortly after the procedure was completed. This is because, apart from the corticosteroids, the doctor also injects a local anesthetic, whose effect is going to disappear in a couple of hours. On average, the first results are noticed at about three to five days from the procedure. Provided there are no complications resulting from the procedure, the effect of the occipital nerve block can last from several days to a couple of months. Regular follow-ups to the doctor are going to be necessary, in order to verify if the procedure was efficient or not.

In conclusion, the occipital nerve block is a very useful procedure for those who are suffering from chronic headaches, neuralgias or migraines. It is easy to perform, does not require general anesthesia and it has very few associated risks or side-effects. The best thing is that it can be repeated, providing significant pain relief and also relief from the other symptoms the patient experiences. The occipital nerve block is a suitable procedure for those who were diagnosed with painful syndromes in the head or neck area, improving their overall quality of life.

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