Occipital Nerve Block

Frequently Asked Questions on Occipital Nerve Block

 

What is an Occipital Nerve Block?

It is a minimally invasive procedure that can be performed as an outpatient procedure. It is a great pain management technique for many different types of headaches. It can help with:

  • Chronic and Episodic migraines
  • Episodic and Chronic cluster headaches
  • Tension headaches
  • Occipital neuralgia

What to expect?

Before the occipital nerve block procedure, an anesthetic may be applied to the area to minimize any discomfort from the injection. The patient is positioned to expose the occipital area and then the area is sterilized. A needle is inserted and medication that is usually mixed with a local anesthetic is inserted near the occipital nerve. The medications will help block the pain signals that go to the brain which will reduce the headache pain.

The patient may feel numbing in the area after the insertion. It is a good idea to stay for at least fifteen minutes after the injection to ensure that there are not any adverse reactions to the procedure.

How long does it take to work?

Some patients may experience relief soon after the procedure or even instantaneous while others feel results in a few days. The results vary from patient to patient. It usually lasts a few months and can be repeated as needed.

Who should receive an occipital nerve block?

The procedure works great for patients with severe to moderate headache pain that normal oral analgesics can’t help. It may help patients with migraines as well. It works well as a rescue treatment or as a treatment for patients who have a headache due to the over-use of certain medications.

Are there cases where it won’t help?

Research has shown that is not an appropriate treatment for hemicranias continua, chronic paroxysmal hemicranias, and tension headaches. There are some cases where it won’t work for certain individuals as well. The results will vary from patient to patient.

What Are the Risks involved with Occipital Nerve Blocks?

The patient may experience discomfort or tenderness at the site of the injection after the occipital nerve block. It should go away in a few days after the procedure. Some other side effects may include bleeding or infection at the site of the injection and hematomas. Some patients have adverse effects to the corticosteroid which include skin discoloration, emotional disturbances, and swelling.

Some adverse reactions to the anesthetic medication may occur as well including a temporary headache, sensory changes, chest discomfort, and nausea. There have been some cases where neurological complications have occurred including transient facial palsy. This is usually temporary and stops within five hours after the injection. This is likely caused by the spread of the anesthetic solution unintentionally along the tissue planes.

Lavin PJ, Workman R. Cushing syndrome induced by serial occipital nerve blocks containing corticosteroids. Headache 2001;41:902-904

Strauss DO, Lauren, Loder MD, Elizabeth, and Rizzoli MD, Paul. (2014). Transient Facial Nerve Palsy after Occipital Nerve Block:   A Case Report. Headache: The Journal of Head and Face Pain. Volume 54, Issue 10, p. 1651-1655.