FAQs on Occipital Nerve Block in Nashville TN

The greater occipital nerve and the lesser occipital nerve arise between the first and second cervical (neck) vertebrae. These nerves supply sensation to the skin along the top of the head and back region of the scalp. The occipital nerves can become irritated, causing pain to be perceived near the eye on the same side of the head, which is called referred pain. In addition, these nerves often contribute to headaches. The occipital nerve block is done to reduce headache in the front of the head.

What conditions are treated with an occipital nerve block?

The occipital nerve block involves injecting an anesthetic near the occipital nerves. Pain relief is often immediate and can last for several days. The occipital nerve block is done to manage migraine or cluster headaches, pain that affects the back or side of the head, pain that is shooting, stinging, burning, or zapping, and spondylosis of the cervical facet joints. In addition, this procedure is effective for occipital neuralgia, which is pain that often follows injury to the nerves.

How is the occipital nerve block procedure performed?

The area of the scalp is cleansed with an antiseptic solution, and the doctor numbs the skin with a local anesthetic. With a very fine needle, the doctor injects a corticosteroid and anesthetic into the scalp where the trunk of the nerve lies. Pain relief is often immediate, and the doctor asks questions during the injection. The full effect of the occipital nerve block is not felt for 2-3 days, but pain relief can last for several months.

What can I expect after the occipital nerve block?

After the occipital nerve block, the doctor recommends that you take it easy for the remainder of the day. You will be permitted to return to usual activities the day after this procedure. The tenderness at the injection site will persist for 6-12 hours, but can be relieved with applying ice packs several times a day.

What are the benefits of the occipital nerve block?

Two main benefits are associated with the occipital nerve block. First, it is helpful to relieve or reduce pain in the back region of the head. Second, the block is useful for diagnosing occipital neuralgia. If symptoms improve after the first injection, the doctor may have you return for repeat injections. The number of occipital nerve blocks required varies from person to person, but injections are usually given one week apart. A second block is only done when symptoms are not relieved within 7 days.

What side effects, risks, and complications are associated with the occipital nerve block?

The most common side effect associated with the occipital nerve block is mild pain at the injection site as the anesthetic wears off. Some patients experience side effects to the corticosteroid, which include water retention, increased irritability, and elevated blood sugar. As with any injection, there is a slight risk for nerve damage, blood vessel injury, bleeding, and infection.

How many occipital nerve blocks do I need?

The number of occipital nerve blocks required varies from patient to patient. The injections are typically done one week apart, and a second block is only necessary if the first one does not relieve your symptoms in 7 days. It is hard to predict if the first occipital block will work.

Are occipital nerve blocks effective?

In a clinical trial, the success rate of the occipital nerve block was reported at 96%, with participants having 6-months of pain relief with these injections. In another study of the occipital nerve block for facial pain, the majority of patients reported 50% pain reduction or more. The efficacy rate was reported between 75-100% in this study, with patients reporting sustained benefits for up to 3 months.

Resources

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

Jurgens, TP, Muller, P, Seedorf, H et al. (2012). Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain. Journal of Headache Pain, 13(3), 199-213. doi:  10.1007/s10194-012-0417-x

Naja ZM, El-Rajab M, Al-Tannir MA, Ziade FM, & Tawfik OM (2006). Repetitive occipital nerve blockade for cervicogenic headache: Expanded case report of 47 adults. Pain Pract, 6:278–284.