Occipital Nerve Block
(Targeted Relief for Headaches and Occipital Neuralgia)
Overview
An occipital nerve block is a minimally invasive injection used to relieve pain stemming from the greater and/or lesser occipital nerves, located at the base of the skull. These nerves can become irritated due to trauma, inflammation, or chronic strain—leading to headaches, scalp tenderness, or neck discomfort
At Restore Spine and Pain, we use ultrasound guidance to safely and precisely target the occipital nerves. In certain situations, fluoroscopic (X-ray) guidance may also be used to enhance accuracy depending on patient anatomy or clinical factors. This procedure offers both diagnostic and therapeutic benefits for a variety of headache syndromes.
Conditions Treated
- Occipital Neuralgia
- Post-Traumatic Headache
- Chronic Migraine (when occipital nerve involvement is suspected)
- Whiplash-associated headaches
- Headaches related to auto injuries or work-related trauma
What are the risks and side effects?
Risks and side effects are minimal, and serious complications are rare. We take every precaution to ensure your safety. Potential risks may include but are not limited to:
- Temporary increase in pain
- Local bleeding, swelling, or infection
- Dizziness or vasovagal response (fainting)
- Numbness at the back of the head
- Allergic reaction to medication
- Elevated blood sugar in diabetic patients
Ask your provider if you have any concerns. Your physician will review the risks in detail before the procedure to ensure you are fully informed.
Sedation:
Most procedures can be performed comfortably without sedation. However, if you have anxiety or difficulty lying flat, mild sedation may be offered at the discretion of the physician. Please discuss this with your provider in advance.
Special Instructions for Diabetic Patients:
Steroid injections may raise blood sugar levels for several days.
- Please contact your primary care physician or endocrinologist prior to the procedure for management recommendations.
- Monitor your glucose closely after the injection.
- Report sustained elevations to your managing provider.
What if I am pregnant?
If there is any chance you may be pregnant, please notify our team immediately and postpone the injection until pregnancy is ruled out.
What If the Block Wears Off?
If pain relief is only temporary or the condition is chronic, other advanced treatment options may be considered. One such option is Peripheral Nerve Stimulation (PNS)—a minimally invasive therapy in which a small device delivers gentle electrical pulses to the occipital nerves to modulate pain signals. If your response to the injection is positive but short-lived, PNS may be an appropriate next step in your care.
Pre-Procedure Information
How Should I Prepare?
- Driver Required: We ask that you arrange for a driver to take you home after the procedure.
- Food: You may eat a light meal 1–2 hours prior to the procedure. If sedation is planned, please follow the specific sedation protocol provided by our team.
Medications:
- Continue routine medications unless directed otherwise.
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Blood thinners, Aspirin, NSAIDs, and supplements:
- Inform us in advance if you take blood thinners (e.g., Plavix, Eliquis, Xarelto, Coumadin), NSAIDs (e.g., ibuprofen, naproxen), Aspirin, or supplements that increase bleeding risk.
- Certain medications may need to be stopped for a short period of time before the injection.
- Speak with your prescribing provider to ensure it’s safe to temporarily stop these medications
- Our team will review your medication list and coordinate with your other providers if needed.
Notify us if:
- You have a fever, infection, or recent illness
- You have started antibiotics or had changes to your medications.
Procedure Information
The procedure is performed using sterile technique under real-time ultrasound guidance.
What to Expect:
1. Preparation:
- You will be positioned on the procedure table.
- The skin will be cleaned and numbed with a local anesthetic.
2. Injection Process:
- A small needle is used to inject a combination of local anesthetic and sometimes steroid near the occipital nerve(s)
Monitoring:
- You will be monitored during the procedure to ensure comfort and safety.
- Most procedures last 10-15 minutes, followed by a brief recovery period on-site.
Post-Procedure Information
What to Expect After the Procedure
- Relief Timeline: Steroids typically begin to work within 2 to 5 days, but in some cases may take up to 2 weeks.
- Activity:You may resume light activities the next day; avoid strenuous activity for 24 hours. We recommend you return to work the following day.
- Soreness: Temporary soreness at the injection site is common.
- Pain tracking:Keep a log of symptoms over the next 1–2 weeks
If successful, additional injections may be spaced out over time.
Additional Instructions:
- Contact the office for any signs of infection, fever, or worsening pain.
- Attend follow-up as scheduled.
Schedule a Consultation
If you're suffering from persistent headaches, neck pain, or scalp tenderness that may be nerve-related, an occipital nerve block may help. Contact Restore Spine and Pain today to schedule a consultation and explore your treatment options.