Occipital Nerve Blocks

The occipital nerves run from the top of the neck up across the back of the scalp. When these nerves are irritated, they can cause sharp, shooting, or aching pain at the base of the skull and the back of the head, sometimes spreading toward the eye. An occipital nerve block places numbing medicine, often with a steroid, next to these nerves to calm them.

It is a quick injection, usually done in the office.

• Occipital neuralgia (shooting or electric pain at the back of the head)
• Headaches that start in the neck, called cervicogenic headaches
• Some migraine and cluster headaches
• Headaches related to neck arthritis or chronic neck pain

Headaches at the back of the head that come on with coughing or straining can also be a sign of Chiari malformation, which is why Dr. Grunch looks carefully at the cause before recommending treatment.

• Tell the provider if you take a blood thinner or have allergies to numbing medicine.
• No fasting is needed.
• Most people can drive home, but bring a driver if this is your first block and you are unsure how you will feel.

You sit or lie face down. The skin at the back of the head is cleaned, and a thin needle is placed near the nerves, sometimes using ultrasound. The injection takes only a few minutes. The back of your scalp may feel numb soon after.

Relief from the numbing medicine can be immediate. The steroid, if used, may provide longer relief over the following days. Relief can last days to months, and blocks can be repeated. For people who get only short relief, other options may be discussed.

Occipital nerve blocks are very low-risk. Possible side effects include soreness, brief dizziness, and, rarely, infection or bleeding. If a steroid is used, there can be small changes in the skin at the injection site.

What does an occipital nerve block treat?

It treats pain at the back of the head and base of the skull, such as occipital neuralgia and headaches that start in the neck, and sometimes migraines.

How quickly does an occipital nerve block work?

The numbing medicine often works within minutes. Any steroid takes a few days to reach its full effect.

If you have neck pain, back pain or nerve pain and want to know which treatments make sense for you, call 470-293-9800 or contact us to schedule a visit with Dr. Grunch or one of her physician assistants. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All non-surgical treatment options · Chronic neck pain · Chiari malformation

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms and treatment options.