Occipital Nerve Blocks
A quick office injection at the back of the head to relieve occipital neuralgia, headaches that start in the neck, and other stubborn headaches.
What is an occipital nerve block?
The greater and lesser occipital nerves run from the upper neck across the back of the scalp. When they are irritated, they can cause sharp, shooting, or electric pain from the base of the skull over the head, often with scalp tenderness. This is called occipital neuralgia.1
An occipital nerve block places numbing medicine, sometimes with a steroid, next to these nerves. It can calm the nerve, break a cycle of frequent headaches, and help confirm where the pain is coming from.2
- Occipital neuralgiaSharp or shooting pain at the back of the head and scalp
- Cervicogenic headacheHeadache that starts in the neck and spreads forward
- Migraine and cluster headacheAs one part of a broader headache treatment plan
How it works
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Find the nerve
Your clinician locates the nerve at the back of the head, where it is often tender.
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Small injection
A very thin needle places numbing medicine, and sometimes a steroid, next to the nerve.
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Scalp numbness
Numbness over the back of the scalp is a sign the block reached the nerve.
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Back to your day
The injection takes a few minutes, and you can usually drive yourself home.
- FastDone in a few minutes during an office visit.
- Low riskUses small needles and small doses of medicine.
- Can be repeatedBlocks can be repeated when they help.
- Fits with other careWorks alongside headache medicines and physical therapy.
What to expect
Before your block
Tell us about your medications, including blood thinners, and whether you are pregnant or have had fainting with injections. Please don’t stop any medication on your own.
During your block
You sit or lie comfortably. The skin is cleaned, and you’ll feel a brief pinch and pressure. Both sides can be treated at the same visit.
After your block
The scalp may feel numb for several hours. Relief can begin within minutes and may last days to weeks or longer. Keep a headache diary so we can see how well it worked.
Common questions
How long will it help?
It varies. Some people get relief for a few days, and others for weeks or months. If it helps, the block can be repeated.2
Will a steroid be used?
Sometimes. Expert recommendations suggest a steroid may be most helpful for cluster headache, while numbing medicine alone works well for many other headaches.2
Will it shave or mark my hair?
No shaving is needed. The injection is made through the hair after cleaning the skin.
Will insurance cover it?
Most plans cover occipital nerve blocks for occipital neuralgia and other headache conditions. Our staff can check your benefits.
Talk with a specialist about headaches
Our physicians will review your headache history and exam to decide whether an occipital nerve block, or another treatment, is the right fit for you.
New pain management patients need a referral. Your provider can fax it to 870-706-2428.
Risks
Possible side effects include tenderness at the injection site, lightheadedness or fainting, temporary numbness, bleeding, and, rarely, infection. A steroid can occasionally cause hair thinning or skin changes at the injection site. Your clinician will review the risks with you. Individual results vary.
Sources
- National Institute of Neurological Disorders and Stroke. Headache. ninds.nih.gov
- Blumenfeld A, et al. Expert consensus recommendations for the performance of peripheral nerve blocks for headaches: a narrative review. Headache. 2013;53(3):437-446. doi:10.1111/head.12053