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Occipital Nerve Block

Many people with chronic headaches located around a specific area of the head may be experiencing an irritation of the occipital nerve. This is called occipital neuralgia.

This nerve is located near the base of the skull. Chronic irritation or inflammation of this nerve can result in chronic headaches. An occipital nerve block can help with this pain. A small amount of local anesthetic (numbing medication) and a steroid (anti-inflammatory) is injected around this nerve.

Patient guidelines (PDF) ›

Procedure overview (PDF) ›

What is the goal of an occipital nerve block?

The goal of an occipital nerve block is to provide pain relief so that you are able to resume normal activities.

The steroid helps to decrease inflammation in the specific location where it is most needed and helps avoid the potential side effects of taking a steroid or other medications by mouth, which can then spread to other areas of the body where they may not be needed.

The steroid may help the nerve heal by reducing inflammation. It may also provide permanent relief or relief over a period of a few weeks/months while the nerve is healing.

What happens before treatment?

You will be escorted to a room where a nurse will conduct a pre-procedure interview.

The physician who will perform the injection reviews your medical history, previous imaging studies, current medications and physical exam results in order to help plan the best approach for the injection. If you have not had a physical exam prior to the injection, the physician will perform an exam at this time.

What happens during the occipital nerve block?

You will remain awake and seated upright during the entire process.

Following sterilization of the injection site with rubbing alcohol, a small needle is inserted into the scalp and the medication is injected.

The entire procedure typically takes two to three minutes.

Should I limit my activity or change my diet after the injection?

No. Unless your doctor tells you otherwise, you may return to your usual activities.

Are there any side effects caused by an occipital nerve block?

  • The most common side effect is pain at the site of injection.
  • Other side effects include infection, bleeding, dizziness, weakness, numbness and lightheadedness. These effects are temporary and often last only six to eight hours.

For diabetic patients

If you have diabetes, it is important to know the steroid (anti-inflammatory) can cause an elevation in your blood sugar level for up to two weeks after the injection. You should check your blood sugar more often than usual for several days after an epidural steroid injection. If your blood sugar is elevated, please contact the doctor who manages your diabetes for instructions on how to change your diet and/or adjust your diabetes medication.

Are there any restrictions after an occipital nerve block?

Yes. You should follow these restrictions after the procedure:
  • Do not drive for the remainder of the day.
  • Do not take a tub bath or soak in water (pool, hot tub) for 24 hours after the injection.
  • Wait three days after the procedure before resuming physical therapy.

What are the medications used for an occipital nerve block?

  • Lidocaine or bupivacaine are local anesthetics that are used to numb the area of injection; this numbness usually wears off within two to six hours.
  • Dexamethasone, a steroid that helps with inflammation and pain, is usually used as well.

When should I call my doctor?

You should call your doctor immediately if any of the following occurs:
  • Swelling, redness, bleeding or discharge from the site of the injection
  • A fever greater than 100˚F
  • New or worsening back or neck pain
  • New numbness or weakness in your arms or legs
  • Chest pain, shortness of breath or persistent cough
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