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Occipital Nerve Blocks

An occipital nerve block is an injection of a steroid or topical anesthetic around the greater and lesser occipital nerves located on the back of the head just above the neck. The steroid reduces the inflammation and swelling of soft tissue around the occipital nerves, thus reducing pain and other symptoms caused by inflammation of the nerves and surrounding structures. Typically, headaches over the back of the head — including certain types of tension and migraine headaches — may respond to occipital nerve blocks.

Ultrasound Guided

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How is the occipital nerve block performed?

It is done with the patient seated or lying down. The skin and hair of the back of the head are cleaned with antiseptic solution and then the injection is carried out. The entire procedure takes only a few minutes without the need for sedation.

Will the occipital nerve block hurt?

The procedure involves inserting a small needle through the skin and deeper tissues, so a very minor amount of pain may be involved. However, the skin and deeper tissues are numbed with a local anesthetic using a very thin needle during the performance of the block.

What should I expect after the occipital nerve block?

Immediately after the injection, you may feel that your pain may be gone or quite less secondary to the local anesthetic. Depending on the type of anesthetic used, this may only last for a few hours with a return of mild pain until the steroid is able to start working — usually within 48 hours and may last several months. Most patients can drive themselves home without complications, although it is advised to take it easy for a couple of hours after the procedure. You may want to apply ice to the injected area. You can perform any activity you can tolerate.

What are the risks and side effects of occipital nerve blocks?

Generally speaking, this procedure is safe. However, with any procedure there are risks, side effect, and the possibility of complications. The most common side effect is temporary pain at the injection site. Uncommon risks involve infection, bleeding, worsening of symptoms, etc. Fortunately, serious side effects and complications are uncommon. If you are allergic to any of the medications to be injected, if you are on a blood-thinning medication, if you have an active infection going on, or if you have poorly controlled diabetes or heart disease, you should not have an occipital nerve block or should at least consider postponing this procedure.

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