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Occipital Neuralgia

Switch ON off with Occipital Nerve Block Injections

Occipital Neuralgia (ON) is a debilitating type of headache, often confused with migraines. The pain usually starts in the back of the neck and spreads to the scalp on one or both sides of the head. This condition happens due to damage or inflammation of the occipital nerves. Sometimes, it can be a product of an injury or an underlying disease.

Occipital nerve block injections can help you manage the symptoms of ON so you can go back to your normal life.

Burning pain
The pain is often described as a piercing, throbbing, electric shock. You may also experience movement sensitivity.

Affected areas
You may feel this pain in the upper neck, the back of the head, behind the ears, and the eyes.

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Key Facts About Occipital Neuralgia

Common symptoms
A continuous aching accompanied by shooting or shocking pains. The scalp may feel tender to touch. You may also feel sensitivity to light and movement.

ON vs. migraines
Migraines are caused by changes in the brain, while ON is produced due to inflammation or compression of the nerves. Often, migraines also cause nausea.

Possible causes
ON occurs when a nerve is pinched at the root of the neck. Injuries or traumas, tight muscles, osteoarthritis, diabetes, tumors, and gout can produce this.

How Occipital Nerve Block Injections Work

A positive response to nerve blocks can help confirm the diagnosis. Nerve blocks consist of injecting a local anesthetic and a steroid anti-inflammatory drug in a specific nerve or group of nerves. This stops pain signals from arriving in the brain.
One of our pain specialists may recommend occipital nerve blocks or other pain management procedures (like trigger point injections, or radiofrequency ablation) depending on your specific case.

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Important Facts About Nerve Block Injections

Diagnostic tool

We can use nerve blocks to diagnose a pain condition. If the procedure works, it can be used as a treatment.

Short procedure

The procedure only takes a few minutes. It usually takes place in a regular exam room and doesn't require any preparation.

Pain relief

Nerve blocks provide temporary pain relief. You can repeat injections to continue managing occipital nerve pain.

FAQ About Nerve Blocks

How do I know I have occipital neuralgia?


The most common symptom of ON is a headache that starts in the back of the neck and radiates to the head, the back of the eyes, or the ears. Patients usually feel this on one side of the head.

The duration of the ON symptoms may vary in each person. For some patients, they can last a few hours, for others, several days.

Symptoms can disappear for long periods of time for some people, while others may suffer from symptoms that are so severe and frequent as to be incapacitating.

Usually, occipital neuralgia can be treated efficiently using pain medications and other pain management therapies. In severe cases, your doctor may recommend procedures like nerve blocks and pain injections to block signals coming from the occipital nerves.

What are occipital nerve blocks?


Occipital nerve blocks are shallow injections in the scalp. We often use this procedure to diagnose and treat chronic pain conditions that affect the neck or the head, such as occipital neuralgia, migraines, and cluster headaches.

The nerve block injection contains a combination of a local anesthetic and a steroid medication. The doctor injects this mix into the scalp, where the trunk of the occipital nerve is.

The diagnosis of occipital nerve pain is usually confirmed by a nerve block trial. By observing the patient's response, the doctor is able to determine if these nerves are actually the ones causing discomfort.

How do occipital nerve blocks work?


Occipital nerves travel from the spinal cord to the scalp. Inflammation in these nerves causes pain in the skull base, which can radiate to the head, behind the ears, or the eyes.

Occipital nerve blocks are injections of anesthetic near or within these nerves. This "blocks" the pain signals before they reach the brain and reduces inflammation. Pain blocks may be used along with other therapies in order to have a better effect.

What happens before a nerve block procedure?


The doctor will review your symptoms and ask you about your medical history, habits, and other relevant matters. He may also ask you to take some imaging studies. If you have any questions, let the doctor know before the procedure.

If you take blood thinners, like Aspirin, the doctor may ask you to stop taking them before the nerve block procedure, in order to avoid complications. Tell them if you take any other medication.

How is the occipital nerve block procedure?


The procedure is usually performed on an outpatient basis. The procedure takes about 30 minutes to complete and you will be awake the entire time.

One of our occipital neuralgia specialists will ask you to lay on your stomach. They will clean the back of your neck and apply an anesthetic.

Then they’ll inject the nerve block in the occipital nerve using a thin needle. You’ll be able to go home immediately after the procedure and return to your everyday activities 24 hours later.

Do occipital nerve block injections hurt?


You may feel some discomfort and pressure during the procedure. However, the doctor uses a local anesthetic to numb the skin and deeper tissues.

How effective are occipital nerve blocks?


Occipital nerve blocks are a very effective way to treat occipital neuralgia, providing moderate to significant pain relief.

The effects of this procedure usually last for several months. Patients with chronic pain conditions in the head and neck usually have about three to four injections a year.

Occipital nerve blocks tend to be more effective in patients whose pain is relatively recent. We can help you treat occipital neuralgia at our treatment center.

What will I feel after an occipital nerve block procedure?



After the local anesthetic fades away (a few hours after the injection), you may feel some soreness for a couple of days. The doctor may recommend some over-the-counter prescriptions to ease the pain.

After the procedure, the doctor will ask you to rest for a while. You should be able to return to your normal activities several hours after the procedure.

Most patients start feeling pain relief three to five days after the injection. If you do not experience significant pain relief, the occipital nerves may not be the cause of your pain. The doctor should do further testing to find out what’s causing the pain.

Am I a good candidate for occipital nerve blocks?


When you experience persistent or recurring headaches that are primarily found on one side of the head, you may be a candidate for occipital nerve blocks.

One of our pain doctors will create a special treatment plan for you depending on your diagnosis, considering your medical history and individual needs. They will decide if occipital nerve blocks are the best option for you.

Typically, occipital nerve blocks are recommended for patients who have already tried traditional treatments, like medication.

Some of the reasons your doctor may decide not to use nerve blocks on you are:

  • You are allergic to any of the components to be injected.
  • You have diabetes, glaucoma, or heart disease.
  • You are taking anticoagulant medications.
  • You have an active infection.

How long does it take to start working?


Some patients experience an instantaneous effect, for others, it can take a week. Everybody responds differently to nerve blocks.

Remember this is a temporary solution for pain.

How many occipital nerve blocks should I have?


This depends on each case.

In a six-month period, it is rare to do more than three occipital nerve blocks. The more injections performed, the greater the chance of developing side effects. If you need more frequent injections, you and your doctor should consider other treatments.

Are occipital nerve blocks safe?


Yes. In general, nerve blocks are safe and effective. As with any procedure, there are risks, side effects, and complications. Temporary pain at the injection site is the most common side effect.

Do occipital nerve blocks have side effects?


Side effects are very rare. However, you may feel some tenderness or dizziness. As with any procedure that involves penetration of the skin, you may develop an infection from the injection itself.

If you develop symptoms of fever or bleeding you should inform your doctor.

Can I leave occipital neuralgia untreated?


Untreated occipital neuralgia can lead to other problems, such as sleeping problems and poor quality of life. You can lower the risk of developing these complications by letting a specialist diagnose your condition, and by following the treatment plan that they design for you.

If left untreated, occipital neuralgia doesn’t lead to neurological or nerve problems.

Remember you should always visit a doctor so they can define the best treatment for you.