Occipital Nerve Block

What is an Occipital Nerve Block and why is an injection helpful?
This is an injection into an area in the back of the head and neck where the occipital nerves are located. This block is useful in the diagnosis and treatment of headache pain due to occipital neuralgia.

Some temporary pain relief is usually felt fairly quickly after the injection due to the local anesthetic.

What happens during the procedure?
You will be asked to lie on your abdomen on a stretcher. The skin at the back of the head in the areas to be injected will be cleansed with antiseptic solution. The doctor will inject a mixture of medications including local anesthetics and a corticosteroid. There will be some initial sting and burn in the sites injected before the numbing effect takes place. The injection procedure itself is very brief usually lasting less than 10 minutes. The patient may experience a short period of increased headache as the medicine is injected, but this usually disappears quickly.

Manual pressure with gauze is applied to decrease bruising after the injection. This area of injection in the head and neck has a high blood supply and bruising occurs easily.

What happens after the procedure?
The patient is observed for at least 15 minutes (30 minutes for 5% Lidocaine)
in the Pain Service area for response to the injection. Blood Pressure and pulse will be monitored.

The patient may be scheduled for a physical therapy protocol to be initiated after the injection.

A follow-up plan will be made.

The headache may return when the local anesthetic wears off in a few hours. There may also be some soreness at the injection sites. These experiences are normal and not unexpected. The soreness at the injection sites should go away in a couple of days. When the corticosteroid is used, pain relief or lessened pain may occur in 3-7 days as the benefit of the steroid medicine is realized.

General Pre/Post Instructions:
There is no restriction of food or medicines prior to this procedure. You may expect to be at the pain service for 1-1 ½ hours with this procedure. You may drive home after this procedure.

Patients may return to their normal activities the day after the procedure, including returning to work unless otherwise instructed by the physician.