Occipital nerve blocks can be effective in treating chronic pain in the head and shoulders. Many patients suffering from chronic headaches describe the pain as typically beginning in the neck or the base of the skull. Blocking the occipital nerve can help reduce these pain impulses from reaching the brain.
There are two greater occipital nerves rising from between the first and second cervical (neck) vertebrae, one on each side of the head. They make their way from the neck through muscle into the scalp to supply sensation to the skin along the back of the scalp to the top of the head.
Any irritation or inflammation of the occipital nerves can cause pain (occipital neuralgia) and contribute to headaches. Occipital neuralgia may occur spontaneously or as the result of a pinched nerve root in the neck (from arthritis, for example). Sometimes “tight” muscles at the back of the head can entrap the nerves. Occipital nerve irritation may also be from a prior injury or surgery to the scalp or skull.
When the occipital nerve becomes irritated, it can cause a shooting, zapping, electric, or tingling pain similar to trigeminal neuralgia. However, occipital nerve pain occurs on one side of the scalp rather than in the face, as with trigeminal neuralgia. When irritated, the area where the occipital nerves enter the scalp may be extremely tender. In some patients, the scalp becomes exceptionally sensitive to even the lightest touch, making washing the hair or lying on a pillow nearly impossible. In addition, some patients may experience numbness in the affected area. Pain from the occipital nerve is often confused with a migraine or certain other types of headaches.
What Is an Occipital Nerve Block?
An occipital nerve block is a nonsurgical, minimally invasive medical procedure to relieve chronic pain in the head and shoulders from an irritated occipital nerve. The procedure involves the injection of medication into the back of the head to help reduce the irritation of the occipital nerve. Also, the injection may help relieve chronic headaches and other head pain by blocking pain impulses from reaching the brain.
If an occipital nerve block injection provides temporary relief, radiofrequency ablation may be an option for some patients for longer-lasting pain relief. Radiofrequency ablation uses radio waves to heat and destroy a small area of nerve tissue to stop it from sending pain signals to the brain. This procedure can provide prolonged relief for some patients’ chronic pain originating in the neck.
Conditions Treated with Occipital Nerve Blocks
Some of the different types of pain an occipital nerve block can help relieve include:
Occipital neuralgia. Pain that comes from the inflammation or irritation of the occipital nerves. Occipital neuralgia can follow trauma to the nerves in the back of the head. This type of pain typically occurs as a direct result of trauma (such as a blow to the head) and is felt throughout the area the occipital nerve enervates.
Migraines. The occipital nerves may act as transmitters of pain signals that cause migraines. An occipital nerve block can also help headaches that aren’t directly caused by nerve irritation.
Cluster headaches cause intense pain around one eye on one side of the head. This type of headache may wake you up in the middle of the night.
Cervicogenic headaches (originating in the neck) build over time and are not necessarily a result of trauma. The cause may be spondylosis (age-related deterioration in the neck) or damage in the neck’s facet joints.
A tender or painful scalp resulting from an inflammation of the occipital nerve.
Shooting, zapping, stinging, or burning pain that affects the back or one side of the head.
Spondylosis of the cervical (neck) facet joints.
An occipital nerve block can not only treat pain but can also be a diagnostic tool to help locate the source of pain. Unfortunately, it is often difficult to tell the difference between pain that starts in the occipital nerves and pain originating in another part of the spine.
How Does an Occipital Nerve Block Work?
During an occipital nerve block, medicine is injected into the scalp, where the trunk of the occipital nerve is located. The injection causes the scalp on the side of the head of the injection to go numb.
If there is a lot of swelling in the occipital nerve, the injection may also include a steroid to reduce the inflammation. The steroid may take two or three days to take full effect, but the effect may last for several weeks or even months.
The best responses to an occipital nerve block are usually in patients whose pain is relatively recent rather than long-standing. However, a series of injections may be necessary to treat the pain fully. If the injections do not provide pain relief, the occipital nerves are not the source of the pain.
Who Can Benefit from an Occipital Nerve Block?
Occipital nerve blocks are not for all pain patients. However, for some patients, the block can be a more effective means of suppressing chronic headaches than oral medications. Participants in one study reported the following positive outcomes after receiving an occipital nerve block:
A reduction in oral analgesic consumption.
Shorter headache duration.
Reduction in nausea.
Reduced sensitivity to light and sound.
Better quality of life.
Ability to resume normal daily activities.
The pain relief from an occipital nerve block varies from patient to patient. Some may experience profound relief after only one injection. However, additional injections may be necessary if the first one doesn’t relieve the pain in a week or two. Often, additional nerve blocks may be necessary to keep the symptoms under control.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including occipital nerve blocks. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.