Occipital Nerve Blocks

We all know that headaches can come in a variety of figurative shapes and sizes. Maybe you’ve experienced a headache from staring at a computer screen too long, having to manage a stressful event, or from changes in environmental factors. But what about a headache that just won’t go away, regardless of medication or lifestyle changes? This is where an occipital nerve block can help provide relief. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is aware of just how debilitating headaches can be to a person’s daily life, and are dedicated to helping patients find relief from their chronic headaches. 

What is an Occipital Nerve Block?

An occipital nerve block is an injection of medication into the occipital nerves with a goal to provide relief from chronic headaches and pain. The occipital nerves are located in the back of the head in the cervical spine. There are three types of occipital nerves, which include: 

• Greater occipital nerve (GON): the largest of the three occipital nerves, this nerve provides feeling to the skin of the scalp from the lower back to the top of the head, as well as the ears and around the ears
• Lesser occipital nerve (LON): this nerve is responsible for providing sensation to the side of the back of the scalp, as well as the outer ear
• Third occipital nerve (TON): most vulnerable to damage from whiplash, this nerve provides feeling to the sin on the middle lower back of the scalp

Most people have two of each type of nerves, one on each side of the head. While trauma or damage to any one of these nerves can provide the feeling of pain in the area of trauma, there is also the opportunity for referred pain, which is pain felt in other parts of the head. A good example of this is when irritation or pain happens to one of the nerves but the pain itself is felt around the eye. 

An occipital nerve block is an injection consisting of an anesthetic and usually a steroid, which helps to relieve pain and reduce inflammation. In addition to helping the patient immediately feel pain relief, the block is also used as a diagnostic tool. If the block does not help relieve the feeling of pain, then the pain management specialist will know that the occipital nerves are not the cause of pain, and additional therapies are needed. 

What Does an Occipital Nerve Block Treat? 

Providers use occipital nerve blocks to treat chronic headaches when other pain therapies or lifestyle modifications haven’t worked. While the main two conditions that occipital nerve blocks treat are cervicogenic headaches and occipital neuralgia, other conditions that can be treated include: 

• Migraine headaches
• Cluster headaches
• Nerve irritation
• Effects of whiplash
• Postdural puncture headache

Cervicogenic headaches are headaches that worsen over time and aren’t necessarily a result of a traumatic event. While there are several reasons why someone might experience cervicogenic headaches, the primary causes are related to spondylosis (age-related deterioration in the neck) or damage in the cervical facet joints in the neck. 

Occipital neuralgia occurs as a result of a traumatic event that caused damage to the nerves in the back of the head. Pain can be felt both in the back of the head at the location of the damage, as well as across the entire region where the occipital nerve is located and provides sensation to. 

Patients who have received occipital nerve blocks to treat their chronic pain and reported the following outcomes: 

• Reduced or removed need for pain medication
• Fewer headaches and shorter headache duration
• Increased appetite
• Reduced needed aversion to light and sound
• Reduced feelings of nausea and vomiting
• Better quality of life with ability to enjoy everyday activities

How Does an Occipital Nerve Block Work?

An occipital nerve block works by targeting the occipital nerves that are causing pain sensations to be felt, effectively blocking the brain from feeling these sensations. While most patients experience pain relief after just one treatment, other patients might benefit from additional therapies as well. 

If your pain management specialist deems you are a candidate for occipital nerve blocks, the minimally-invasive and quick procedure is held in an outpatient setting. The patient will sit or lie with the head tilted down. Patients who are anxious can receive a mild sedative, but most patients are comfortable with just a topical anesthetic to numb the skin. Once the patient is comfortable, the provider will use imaging techniques to locate the occipital nerves, clean the skin above the targeted nerves, and then inject the medication into the nerves. The medication is an anesthetic, which helps to provide pain relief, and can sometimes be given with the addition of a steroid, which helps to lessen inflammation.  

The entire procedure takes about 15 minutes and the patient is able to return home shortly thereafter. Most patients report feeling immediate pain relief, but it could take a few days to feel the full effects of the medication. Pain relief can last up to several months, and there could be the need for additional injections to continue to combat the effects of cervicogenic headaches and occipital neuralgia.

What are the Benefits and Risks of Occipital Nerve Blocks?

In addition to providing pain relief for patients who have yet to find relief from their headaches, occipital nerve blocks have two main benefits. They: 

1. Provide immediate pain relief for those who suffer from cervicogenic headaches and occipital neuralgia
2. Can be used as an important diagnostic tool to determine if a patient’s acute or chronic headache pain is caused by the occipital nerves. If an occipital nerve block doesn’t help, then the provider can seek alternative options. 

Patients can benefit from both immediate pain relief, which helps them enjoy a greater quality of life, as well as reduced inflammation in the neck area, which allows the nerves to heal and not create pain sensations in the future. 

As with any injection, there are risks. The great news is that the risks with occipital nerve injections are minimal and rare. Some patients can experience temporary and superficial pain from where the needle was inserted into the skin, and there is also the chance of bleeding, infection and nerve damage. 

It’s important to trust a pain management specialist who is experienced in occipital nerve blocks, considering there are so many nerves in the neck and head area. The goal is to provide pain relief with as few negative side effects as possible. 

If you are experiencing chronic headaches and don’t know where to turn, please reach out to the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas and schedule an appointment today.