Get an Occipital Nerve Block

Therapeutic nerve blocks are injections that interrupt the pain signals that a particular nerve sends to your brain. An occipital nerve block may be recommended to relieve the pain of chronic headaches and certain types of neuralgia. If you believe an occipital nerve block could help you, you can start by consulting your doctor. Later, you might undergo this minimally-invasive procedure, and afterward, you will work with your doctor to manage your pain relief.

Steps

Working with Your Doctor

1. Speak to your doctor. If you suffer from head pain, head aches, or tender scalp consult your doctor to decide whether or not an occipital nerve block is right for you. There are several reasons why your doctor may not recommend a nerve block (or not right away). An occipital nerve block, may not be right for you if:
   • You are allergic to any of the injected medications
   • You currently take blood thinning medication
   • You have an active infection
   • You have diabetes (depending on a number of factors)
   • You have heart disease (depending on a number of factors)
2. Outline your symptoms. The occipital nerve governs specific areas of the head and scalp. As such, an occipital nerve block may be able to relieve very specific types of a head pain. When you speak to your doctor, you will need to explain all of your symptoms, in as much detail as possible. This will help your doctor decide if an occipital nerve block might help. Occipital nerve blocks are generally used to treat:
   • Migraines
   • Cluster headaches
   • Spondylosis
   • Tender scalp (with may be a sign of an irritated nerve)
   • Pain on one side of the head or the back of the head (usually zapping, shooting, or burning pain).
3. Learn about the potential risks. An occipital nerve block is a simple, minimally invasive procedure that is considered safe. However, like all medical procedures, it does carry some risks. Though rare, these include:
   • Infection
   • Bleeding
   • Damage to the nerve
   • Swelling, itching, or pain at the injection site
   • Raised blood sugar levels (from steroid injections)

Having the Procedure Done

1. Apply a topical anesthetic. When you go in to have your occipital nerve block, a topical anesthetic will be applied to the base of neck, where your doctor will insert the needle. This may in the form of a cream, gel, or spray. You will then wait several minutes for the topical anesthetic to take effect.
2. Inject steroids and/or anesthetic into the nerve. You will then lay down on your stomach. Your doctor will carefully insert a very small needle into the occipital nerve at the base of your neck. You should not be able to feel anything. Through this needle, your doctor will inject steroid medication and/or anesthetic that will block the signals coming from your occipital nerve.
   • Your doctor may opt to inject only anesthetic to numb the nerve, or a mix of steroids and anesthetic to reduce inflammation while numbing.
3. Experience numbness and pain relief. For most people, the effects of the injection should occur very quickly, often within moments. For others, noticeable pain relief may require up to one week to take effect.
   • If you do not experience relief within 1-2 weeks, it is possible that your occipital nerve is not the source of your pain.
   • Your doctor may opt to do a second injection and/or explore alternative treatment options

Maintaining Your Pain Relief

1. Keep a "pain log." The length of time that occipital nerve block pain relief lasts can vary greatly from person to person. The way the nerve block effects you can give your doctor clues about the best long-term treatment plan for you. As such, it is a good idea to maintain a "pain log," where you briefly jot down your level of pain (as well as any other symptoms) each day. Try using a number system (such as 1-10) to describe your level of pain.
2. Return for additional injections. If your pain is severe, your initial treatment plan may include doing a secondary injection 1-2 weeks after your initial occipital nerve block. Furthermore, if the injections seem to be working, you will likely need to return for another injection when the pain relief begins to wear off. You and your doctor will work out a treatment plan for if/when you will return for follow-up injections.
   • For some people, a single injection quells the pain. However, most people will return for follow-up injections at some point.
   • The amount of time the pain relief can last will vary widely from person to person.
   • It is rare to do more than three occipital nerve blocks over the course of six months (as this increases the risk of side-effects and complications).
   • If you need more than three injections within the span of six months, your doctor may suggest alternative treatment options.
3. Explore other treatment options. If the injections do not provide sufficient or long-enough lasting pain relief, your doctor may wish to explore alternative treatment options. Some of these include:
   • Cutting a nerve
   • Relieving pressure on a nerve
   • Administering small doses of a poison or radiofrequency energy, to slowly kill nerve cells
   • Inserting an occipital nerve stimulator

Sources and Citations

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