Occipital nerve block

Overview

An occipital nerve block involves the precise injection of anesthetic medication near the occipital nerve to offer temporary pain relief and reduce inflammation associated with headaches or other medical conditions. Steroid medicine is occasionally added to the injection.

A collection of nerves on the back of your skull is called your occipital nerves. They originate from the C2 and C3 spinal nerves (the letter C stands for “cervical,” referring to the neck vertebrae). The occipital nerves come in three different varieties, including:

• Greater Occipital Nerve (GON): Out of the three occipital nerves, this one is the biggest. It gives feeling to your ears, the skin above your parotid glands, your scalp from the lower back to the top of your head, and all of these areas.
• Lesser Occipital Nerve (LON): The pinna, the visible portion of your outer ear, and the sides of the back of your skull are both sensed by this nerve.
• Third Occipital Nerve (TON): The skin on your scalp’s middle lower back is sensed by this nerve. Whiplash can cause injury to the third occipital nerve.

The majority of people have one occipital nerve on each side of their head, or two of each type.

Although these nerves provide feeling to particular areas of your head, irritation or damage to the occipital nerves can occasionally cause you to experience pain elsewhere in or on your head, such as the area around your eyes. Doctors refer to this condition as referred pain.

Reasons for undergoing the procedure

When alternative treatments have failed to reduce the discomfort associated with specific types of headaches, doctors often resort to occipital nerve blocks. Many headache conditions can be treated with an occipital nerve block, such as:

• Headache following a lumbar puncture (postdural puncture headache).
• Occipital neuralgia
• Migraine headaches
• Cluster headache
• Cervicogenic headache

It can help lessen tinnitus and ear pain (otalgia), which are related symptoms of nerve irritation.

Additionally, an occipital nerve block may be used to treat:

• Pain at the upper back of your neck.
• Whiplash injury.

An occipital nerve block may be performed by your doctor as a diagnostic procedure. It can assist them in determining if the discomfort you’re feeling in your head or neck is originating from the occipital nerve or from another location. This may aid in choosing the most effective course of therapy.

Risks

In general, occipital nerve blocks are safe, and problems are infrequent. However, potential dangers or issues include:

• Redness, pain, and swelling at the site of injection
• Dizziness
• Numbness
• Fainting or vasovagal syncope
• Swollen face
• The injection area bleeds or is infected
• Injury to the artery or nerve
• Headache that gets worse
• Short-term difficulty with swallowing (transient dysphagia)

Before the procedure

Usually, there is nothing specific you need to do in order to get ready for an occipital nerve block.

Your doctor could occasionally advise sedation for the surgery. You will need to fast for six to eight hours prior to obtaining sedation. If you were given sedation during the procedure,

you will additionally require a ride home from someone else.
You will receive instructions from your doctor. Make sure you adhere to their guidelines. Never be afraid to ask questions.

During the procedure

In an outpatient context, occipital nerve blocks are commonly administered by doctors to alleviate pain. This implies that you can leave the hospital immediately after the surgery and are not admitted for the procedure.

Generally speaking, following an occipital nerve block, you should anticipate the following:

• You will either lie on your stomach on a treatment table with a pillow under your chest to slightly flex your neck, or you will sit with your head tilted down and supported by your hands.
• To help you relax, you might get an IV line inserted in your arm and be given a light sedative.
• To find the targeted occipital nerve, the doctor will feel the back of your neck. To find the nerve, they might occasionally employ imaging methods like fluoroscopy or ultrasonography.
• They’ll use an antiseptic solution to cleanse the skin on your neck.
• The medicine will be injected as close as feasible to the injured nerve by the doctor.
• You will rest following the procedure until the medication takes action.

No more than five minutes should be needed for the procedure.

After the procedure

You will rest for 15 to 30 minutes following the injection if you were sedated during the surgery. During this period, a nurse will also be monitoring you to make sure you don’t experience any unanticipated side effects. After that, you can return home.

You will rest for around ten minutes if you were not sedated, after which you are free to depart.

Outcome

The degree of pain reduction following an occipital nerve block varies greatly amongst individuals. It can be challenging to forecast the result. Pain relief with an effective occipital nerve block usually occurs 20 to 30 minutes post-injection and can extend for several hours to several months.

For occipital neuralgia and cervicogenic headache, many injections may be necessary to achieve long-lasting pain relief.