Occipital Nerve Block

The occipital nerve block is a simple, safe procedure performed on an outpatient basis. This minimally occipital neuralgiainvasive procedure is used to diagnose and treat certain kinds of head pain.

The two greater occipital nerves are located on each side of the head, emerging from between the vertebrae of the spine in the upper neck. The nerves make their way through the muscles at the back portion of the head, and they supply feeling and sense pain in the head. The occipital nerve block is done to stop the pain signals from reaching the brain.

Why is the occipital nerve block performed?

The occipital nerves perceive pain, as with headaches. The often reach as far forward as the forehead, but not the front of the head. The occipital nerve block is performed to numb these nerves to stop the pain associated with headache.

The best candidates for the occipital nerve block procedure are those who have one-sided head pain, which predominately occurs at the posterior head region. The patients who enjoy best response are those with shooting, stinging, and burning pain, which is seen with migraines, cluster headaches, and other painful conditions of the head.

What can I expect with the procedure?

There are no special steps necessary for preparation for the occipital nerve block. You will lie down on the examination table on your side. The scalp at the back of the head is cleansed with an antiseptic, and the doctor locates the site of the nerve.

Using a small needle, he/she injects a mixture of anesthetic and corticosteroid medication inOccipital_blocksto the scalp near the trunk of the nerve. The scalp on the injected side will go numb and relieve pain immediately.

You will be asked questions about how you feel during the injection. The numbness will wear off after 1 to 3 hours, and the steroid works to decrease inflammation over the next few days.

What happens after the occipital nerve block?

Many patients achieve good results with the temporary occipital nerve block. You will be asked to take it easy for the remainder of the day, but can return to usual activities the day following the procedure. Expect to have some tenderness at the injection site for a day or two. This can be relieved with the use of an ice pack.

Are there any risks or complications associated with the procedure?

While risks and complications are rare with the occipital nerve block, they include bleeding, pain at the injection site, infection, and allergy to the injected medication. A small percentage of patients report that they initially feel lightheaded, but this is only temporary.

How many occipital nerve blocks do I need?

This varies from patient to patient. The injections are usually done one week apart, and a second block is Occipital Nerve Blockrecommended if the first one does not relieve your symptoms in 7 days. It is difficult to predict whether or not the first occipital nerve block will help you.

Who should not have an occipital nerve block?

Anyone who is allergic to local anesthetics and/or corticosteroids should not have an occipital nerve block. In addition, the procedure should not be performed on anyone who is on a blood-thinning medicine, those with an active infection, or individuals who have poorly controlled diabetes.

Do occipital nerve blocks work?

In a recent study of the effects of ONB on facial pain, the response rate was found to be above 50% reduction of original pain. The greatest efficacy was seen in patients with trigeminal neuralgia (75%) and occipital neuralgia (100%). In addition, effects lasted for around 30 days, with sustained benefits observed for up to three months in some patients.


Jurgens, TP, Muller, P, Seedorf, H et al. (2012). Occipital nerve block is effective in craniofacial neuralgias but not in idiopathic persistent facial pain. Journal of Headache Pain, 13(3), 199-213. doi:  10.1007/s10194-012-0417-x