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 Recovery area for response to the injection. Blood Pressure and pulse will be monitored.A follow-up appointment 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 48 to 72 hours as the benefit of the steroid medicine is realized.


General Pre/Post Instructions

Patients may eat a light meal before the procedure. If a patient is an insulin dependent diabetic, they should take their insulin and eat. Patients may take their routine medications. (e.g., high blood pressure and oral diabetic medications). If you are on Coumadin (Warfarin), Plavix (Clopidogrel), Lovenox, Pletal (Cilostazol), Effient (Prasugrel), Teclid ( Ticlopidine), or Pradaxa (Dabigatran), notify the office so that special instructions may be given. If you are allergic to iodine, contrast, or medical dye, please inform the office. Patients can expect to be at the facility approximately 1 1/2 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work unless instructed otherwise by the physician.