Occipital Nerve Block: Is it Right for You?

If you frequent the “headache scene” then you’ve probably started hearing a lot about the occipital nerve block. This is a treatment that is garnering a lot of attention to itself—and the results are definitely something worth considering. –But is it right for you? As with any procedure…especially those that involve your head…it’s always a wise idea to do a bit of digging and see not only what the “pros” are but if there are any reported side effects and risks that you should know about.

What is an Occipital Nerve Block?

An occipital nerve block is a treatment that can help reduce the swelling and inflammation in the tissues at the back of the head (where the occipital nerves are located) that sometimes trigger headaches around the back of the head, tension headaches, and chronic migraines. The basic idea of the procedure is to inject medication directly into the deep tissues and into the greater occipital nerve to “block” the pain by literally numbing it. This obviously isn’t right treatment for individuals that complain of the occasional headache.

The occipital nerve block is best suited for those who experience significant chronic headaches that are based in the back of the head, usually to one side. The condition that this treatment is geared towards relieving is called occipital neuralgia. The symptoms of this condition are sharp or stabbing pains that start off in the back of the head and shoot forward towards the forehead, which may be accompanied by burning or stinging sensations on the scalp. It is not uncommon for an individual with occipital neuralgia to experience tenderness and inflammation of the scalp at the back of the head as the result of compression of the occipital nerve.

How is the Procedure Done?

The patient is awake during the procedure and may, upon request or through the advice of their doctor, be lightly sedated. The patient will lie on a table and then the doctor will start to disinfect the scalp where the needle will be inserted. The doctor may feel around on the scalp to better locate the base of the nerve which is usually a little inflamed to begin with. Once the nerve is located a very thin needles is used to inject the nerve with a cocktail consisting of numbing medication and steroids. If the nerve was injected properly then the numbing effect starts to kick in within a matter of minutes—which can be an amazing relief for someone who suffers intense headaches on a regular basis. If numbness is not achieved then the doctor may try again. Bear in mind that this injection is more or less done by feeling alone so it isn’t uncommon for a few attempts to pass before the nerve is actually located and injected.

What Results can I Expect?

This is a fairly short term procedure, although the results can differ from person to person depending on how they physically react to the treatment, how severe their symptoms are, and the extend of the nerve’s constriction. Most patients seem to experience a few hours of numbness directly after the procedure. The pain may be completely eradicated or it may be dulled. Again, it all depends on the individual case. Bleeding may occur just after the injection but this is to be expected due to the concentration of blood vessels in the head. The area where the needle was injected will be sore for a few days. This is the same sort of sensation that you would have after getting a booster shot—bruising and tenderness to the skin, although it may be a little worse on the scalp which tends to be much more sensitive than your arm or hip. By the time the third day post-procedure rolls along the patient usually experiences some degree of improvement in their headache(s). Some experience total relief while others may still suffer from reduced pain. The effects of the steroids in the block can last anywhere from a few weeks to a few months, which is largely dependent upon the extent of the inflammation in the back of the head.

Are there Risks with the Occipital Nerve Block?

Surprisingly enough, there aren’t many severe risks associated with occipital nerve block. There are the standard potential risks such as infection, worsened headaches, nerve the damage, and hair thinning at the site of the injection. One possible risk involved with this procedure, which could be serious, is an allergic reaction to the anesthetic.

Other Thoughts

Something to consider would be whether your insurance will cover the procedure. Some companies consider this to be a surgical procedure and therefore may not be covered or may require you to pay a hefty co-pay. You may also want to bear in mind that this is not a long term treatment. While it could relieve headaches for up to a few months, the average results involve reduced headaches for one to two weeks. If the treatments work for you—and they don’t work for everyone—you will have to have repeat injections every few months to keep up the relief. If you have a long history of chronic headaches then it might simply be cheaper and easier to look into long term and permanent treatments such as severing the occipital nerve or damaging it with radio energy.