What is an occipital nerve block?
This is an outpatient procedure involving placement of numbing medicine and possibly steroid into the area around the occipital nerves at the base of the scalp. The procedure is excellent for relieving the frequency and severity of various types of headaches along with occipital neuralgia.
For what types of conditions are occipital nerve blocks helpful?
There has been research showing the effectiveness of occipital nerve blocks for migraine headaches, cluster and tension headaches, along with any type of a headache originating from the neck.
In addition, these blocks are very helpful for patients suffering from occipital neuralgia.
What do the occipital nerves do?
There are two occipital nerves on either side of the scalp. One is the greater occipital nerve and the other is the lesser occipital nerve. They are sensory nerves only, meaning they have no motor innervation at all. So deadening them with treatment does not affect any ability to move one’s head.
How is the procedure performed?
An occipital nerve block is an outpatient procedure that takes less than 10 minutes. The pain management physician will palpate in the area where the occipital nerves originate. At the point of maximal tenderness, the skin is sterilized and the needle is placed. Numbing medicine and possibly steroid medication is placed around the greater and lesser occipital nerves, often in a fan type technique.
Image guidance is not necessary for the procedure.
How effective are the injections?
Various studies have looked at occipital nerve blocks. For cervicogenic headaches, over 90% of patients receive an average of six months relief with the blocks. (Naja et al.) For those with cluster headaches, 85% of patients receive relief for up to four months (Ambrosini et al).
For migraine headaches and occipital neuralgia, occipital blocks continue to show impressive results. Eighty-five percent of patients receive up to six months of relief with the procedure. Several procedures may be indicated for optimal results (Anthony M et al).
Are there risks with occipital blocks?
There are some minimal risks which may include infection, some slight bleeding or an allergic reaction. The biggest risk is that the procedure may not work as well as hoped.
As the needle does not go into the spinal canal, there really is no risk of spinal cord or nerve root injury.
If the occipital block works well, it may be repeated every few weeks as necessary. In addition, a radiofrequency ablation procedure of the occipital nerves may help to provide longer-term relief.