FAQ’s on Occipital Nerve Block in Philadelphia

According to statistics, around 5% of the global population suffer from some type of headache pain. The occipital nerve block is a procedure used to treat pain associated with the occipital nerves.

What conditions are treated with the occipital nerve block?

The occipital nerve block is used to treat various types of head pain. Examples of these conditions include:

  • Episodic cluster headaches – These headaches are stabbing pains in or around the eye. They usually occur in clusters, 1-2 times each day for 4-6 week periods.
  • Chronic migraine – Migraine headaches are severe pain of the head, which occur with associated symptoms of visual disturbances, dizziness, nausea, and vomiting.
  • Cervicogenic headache – These headaches are associated with trauma of the neck and/or head. The pain is on the pack of the head, and is triggered by neck movement where pressure is applied to the occipital nerve.
  • Occipital neuralgia – This headache causes stabbing pains at the back of the neck. These result in pain and tenderness at the posterior region of the head.
  • Tension headaches – This is the most common type of headache that is characterized by a band-like sensation around the head.
  • Spondylosis of the cervical facet joints – This condition results from age and wear/tear of the cervical (neck) spinal joints.
  • Inflamed occipital nerves – Overuse, injury, or trauma can lead to inflamed occipital nerves and persistent pain at the back of the head.

How does the occipital nerve block work?

An occipital nerve block blocks and inhibits the signals sent form the brain as perceived as headache pain. These are used for patients who do not respond to usual treatment. Pain at the back of the head and neck will radiate outward toward the skull.

How is the occipital nerve block performed?

The occipital nerve block is a minimally invasive procedure that can be done at the pain management specialist’s office. This procedure involves use of a local anesthetic to numb the skin and involves use of a fine needle to inject medications near or around the occipital nerve. Steroid medications and/or a long-acting anesthetic is used to block the nerves.

What can I expect after the procedure?

Immediately after the procedure, a nurse will monitor the patient for a 15-20. Following the occipital nerve block, you should rest for the remainder of the day. This procedure does not interfere with normal routines and function.

How many occipital nerve blocks are needed?

This depends on the severity of the condition, what procedures the patient has failed on in the past, and the type of medication used. Immediate effects are related to the local anesthetic, and corticosteroids start to work within 3-5 days. The effects of the block lasts for several days to a few months. The doctor will wait 1-2 weeks after this procedure, and additional injections will be given as needed. The doctor can give three occipital nerve blocks in a six-month period.

What is the success rate of the occipital nerve block?

According to a recent clinical trial, the occipital nerve block was used for chronic cluster headache. The majority of patients reported pain relief, with complete pain relief for 42% that lasted for almost 2 years. In other clinical studies, the success rate for this block is between 83-95%, with results lasting for an average of 7 weeks to 6 months.

Resources

Afridi S, Shields K, Bhola R, et al. (2006). Greater occipital nerve injection in primary headache syndromes: Prolonged effects from a single injection. Pain, 122:126–129.

Ambrosini A, Vandenheede M, Rossi P, et al. (2005). Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: A double-blind placebo-controlled study. Pain, 118:92–96.

Naja ZM, El-Rajab M, Al-Tannir MA, Ziade FM, Tawfik OM. Repetitive occipital nerve blockade for cervicogenic headache: Expanded case report of 47 adults. Pain Pract. 2006;6:278–284.

Peres MFP, Stiles MA, Siow HC, Rozen TD, Young WB, Silberstein SB. Greater occipital nerve blockade for cluster headache. Cephalalgia. 2002;22:520–522.

Young WB, Marmura M, Ashkenazi A, Evans R (2008). Expert opinion: Greater occipital nerve and other anesthetic injections for primary headache disorders. Headache, 48:1122–1125.