Occipital Nerve Block

FAQ’s on Occipital Nerve Block

What is an occipital nerve block?

Occipital nerves supply innervation from the area at the base of the skull all the way over to the top of the head. They emerge from between the bones of the spine through the muscles of the back to the top of the head and into the scalp. Pain that is caused by inflammation or irritation of these nerves is called occipital neuralgia.

An occipital nerve block is an injection of a local anesthetic, with or without a steroid, into the area around the occipital nerve. This “blocks” the signals coming from this area, offering temporary relief of symptoms.

What conditions can benefit from an occipital nerve block?

The patients who report the most improvement from this procedure are those who suffer from chronic, unilateral headaches that occur mainly at the occipital area. The exact description of the headache may vary. Headaches have been known to be described as shooting, burning, or throbbing. Conditions that have been successfully treated with occipital nerve block include:

What conditions can benefit from an occipital nerve block?

The patients who report the most improvement from this procedure are those who suffer from chronic, unilateral headaches that occur mainly at the occipital area. The exact description of the headache may vary. Headaches have been known to be described as shooting, burning, or throbbing. Conditions that have been successfully treated with occipital nerve block include:

How is the occipital nerve block performed?

The occipital nerve block procedure is usually performed under local anesthesia, so
you will most likely be awake throughout the procedure. You may also be given a mild sedative to help you relax while it is ongoing.

As part of the sterile technique, the surgical site will be prepped in antiseptic solution, and the surrounding area will be wrapped in sterile surgical drapes.

The injection site may be numbed with a local anesthetic prior to the insertion of the needle. The needle will be inserted through muscle and tissue until the end is near the occipital nerves. This is usually done under fluoroscopic (X-ray) guidance, although emerging techniques have been developed, such as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) scans, and ultrasonography.

Once the needle is in the proper place, the anesthetic and the steroid will be injected. You will feel relief from the pain within minutes. This may wear off before the steroids begin to work, so do not worry if your pain comes back temporarily.

What are the outcomes for occipital nerve block?

Occipital Nerve Block Orange CountyMost studies report that the procedure is highly effective in treating occipital forms of pain. Positive responses have been noted in majority of the patients who have used it for chronic cluster headache, migraine, neuralgia, and other conditions. Most patients report significant relief of the symptoms of headache, with improvement in the quality of life and reduction in pain symptoms. Occipital nerve block has also been shown to relieve the aura (accompanying symptoms) of migraine headache, such as sensitivity to light and sound.

However, the procedure is not without risks. There is always a risk of infection at the surgical site, intraoperative damage to muscles, nerves, and other soft tissues, as well as bleeding and pain at the injection site. These are usually easily managed, and adverse outcomes are rarely reported.

References

Choi HJ, Choi SK, Lee SH, Lim YJ. Whiplash injury-induced atypical short-lasting unilateral neuralgiform headache with conjunctival injection and tearing syndrome treated by greater occipital nerve block. Clin J Pain. 2012;28(4):342-3. doi: 10.1097/AJP.0b013e318234ec39.

Jürgens TP, Müller P, Seedorf H, Regelsberger J, May A. Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain. J Headache Pain. 2012;13(3):199-213. doi: 10.1007/s10194-012-0417-x. Epub 2012 Mar 3.

Lambru G, Abu Bakar N, Stahlhut L, McCulloch S, Miller S, Shanahan P, Matharu MS.

Greater occipital nerve blocks in chronic cluster headache: a prospective open-label study. Eur J Neurol. 2013 Dec 7. doi: 10.1111/ene.12321.

Sahai-Srivastava S, Subhani D. Adverse effect profile of lidocaine injections for occipital nerve block in occipital neuralgia. J Headache Pain. 2010;11(6):519-23. doi: 10.1007/s10194-010-0244-x.