What is an Occipital Nerve Block?

An occipital nerve block is a minor surgical procedure in which an injection of anesthetic and steroids is used to numb the occipital nerve, which is located at the base of the skull. This procedure is used as a treatment for occipital nerve pain caused by nerve disorders or injury and sometimes as a treatment for migraines and other types of headaches. An occipital nerve block can provide relief from nerve pain within approximately 24 hours of the procedure.

There are two greater occipital nerves located on either side of the head. These nerves extend from the top vertebrae of the neck at the base of the skull and cover much of the back and top of the head. These parts of the head can be affected by neuralgia, or nerve pain, when one of the greater occipital nerves is stimulated in an abnormal manner. Typical symptoms of this abnormal stimulation include burning, stinging or shooting pains in the affected area. An occipital nerve block is carried out to lessen the frequency and severity of neuralgia. In some cases, this procedure also can be used to treat migraines and cluster headaches.

During the occipital nerve block procedure, the patient lies face-down on an examination table or might sit down in a chair with his or her head tilted forward to expose the neck. The injection site is sanitized with antiseptic, and the neck area is numbed with an anesthetic injection. Finally, the site is injected with a steroid medication to reduce nerve inflammation and provide long-lasting pain relief. In some cases, the anesthetic and the steroid might be administered in the same injection. The entire procedure takes less than 30 minutes, but patients usually stay in the clinic or hospital for one or two hours to ensure that there are no complications.

Once the occipital nerve block medication has been administered, initial pain relief generally occurs within 15 to 20 minutes. This initial pain relief is temporary, however, because it is a result of the anesthetic. The anesthetic will wear off within a few hours. The steroid medication generally begins working within 24 hours and provides pain relief that can last for weeks or months.

The injection of anesthetic and steroid medications can cause some side effects. The most common minor side effects are swelling, bruising and soreness at the injection site. These can be treated at home with the application of ice or heat, and with pain medication if needed. The cold or heat source should not be placed directly against the skin, in order to prevent skin damage or irritation. Normal everyday activities can be resumed whenever the individual feels ready, but it is best to avoid strenuous activity for several days.