Occipital Nerve Block

Occipital Nerve Block in Denver Colorado


Headache syndromes will often involve pain that arises from inflamed nerves of the back of the neck and head. An occipital nerve block is a simple procedure used in the diagnosis and treatment of painful headaches and neuralgia. Research shows that occipital nerve blocks will relieve headaches with long-term pain relief.


What medications are used for the occipital nerve block?


The injections involve use of a local anesthetic (lidocaine or bupivacaine) and a corticosteroid (methylprednisolone and dexamethasone). The medications are deposited onto the occipital nerves, which run between the skull and scalp at the area of the occiput (back of head).


What conditions are treated using the occipital nerve block?


Research suggests that the occipital nerve block works for headaches caused by affected nerves along the back of the head. Conditions treated with this procedure include:


  • occipital neuralgia
  • cluster headache
  • cervical neck pain
  • cervicogenic headache
  • migraine headache


Is the occipital nerve block effective?


In a recent randomized placebo-controlled trial involving 50 patients with cervicogenic headache, occipital nerve block reduce pain by around 50%. Furthermore, analgesic consumption, frequency and duration of symptoms, and functional status limitations were reduced significantly in these patients, for up to 14 days. A study involving patients with hemicrania continua found that patients with this condition had 10 months of pain relief using the occipital nerve block.


How do I prepare for the occipital nerve block?


Before the occipital nerve block, you will meet with the doctor, who analyzes your condition. After some diagnostic and laboratory tests, the doctor will review the procedure risks and benefits, and have you sign a consent form. When you arrive at the medical facility, a nurse will assess your vital signs.


How is the occipital nerve block used?


After you are positioned on the procedure table, the doctor cleans the scalp region with an antiseptic solution. Using a fine needle, the doctor injects the area with an anesthetic and corticosteroid, which is applied near affected nerves. Most patients have immediate pain relief with this procedure. After the needle is removed, a bandage is applied to injection sites.


Will the block hurt?


Expect to feel a mild pinching sensation during the occipital nerve block procedure. Afterwards, the injection sites may feel a little sore, but this improves after a few hours. Apply a padded ice pack to the scalp for pain relief. Most people can drive themselves home, but it is advised to rest for the remainder of the day. Gradually return to activities as tolerated. Unless you have side effects, you can return to work the next day.


How long does the effects of the occipital nerve block last?


The immediate effects of the block from a local anesthetic wears off in a few hours. However, the corticosteroid begins working after 3-5 days, and these effects last for several months.


How many occipital nerve blocks do I need?


The injections can be given one week apart, but this depends on the individual’s needs and requirements. If you respond to the occipital nerve block, additional injections will be effective. There are only 2-3 injections given over a 6-month period, due to the side effects of steroidal agents.


What are the benefits of the occipital nerve block?


The occipital nerve block has a long, proven track record for efficacy. It has an efficacy rate of 100% in treating pain for patients with occipital neuralgia, according to clinical studies. With a positive treatment, the pain relief can last for over 30 days. Another benefit is that the block has few risks and complications.




Saracco MG, Valfrè W, Cavallini M, & Aguggia M. (2010). Greater occipital nerve block in chronic migraine. Neurol Sci. 31 Suppl 1:S179-80.


Vanelderen P, Lataster A, Levy R, Mekhail N, van Kleef M, & Van Zundert J. (2010). Occipital neuralgia. Pain Pract. 10(2):137-44.


Ward JB. (2003). Greater occipital nerve block. Semin Neurol. 23(1):59-62.