It answers a question and treats the problem in the same needle.

WHAT WE DO · OCCIPITAL NERVE BLOCK

An occipital nerve block places local anesthetic, usually with a corticosteroid, around the greater and lesser occipital nerves at the back of the head. It takes a few minutes, it is done sitting up, and you walk out afterward.

A small injection at the base of the skull that does two jobs at once. It tells us whether those nerves are carrying your pain. If they are, it treats it.

What is an occipital nerve block?

The greater and lesser occipital nerves come out at the back of the head. They supply the scalp from the base of the skull to the crown. A block places local anesthetic, usually with a corticosteroid, around them. It takes a few minutes, it is done sitting up, and you walk out afterward.

Can an occipital nerve block show where a headache comes from?

If your pain settles within the working time of the anesthetic, those nerves were carrying it. No scan can tell you that. It is why the block is worth doing even when the relief turns out to be short-lived. If it does nothing, that is also useful. It rules out one suspect and points the workup elsewhere. It does not just leave you on a longer list of things to try.

How long does an occipital nerve block last?

How long it lasts varies widely: days for some, months for others. There is no fixed course and no magic in a series of three. Spacing is a scheduling fact. How many you have is a clinical call based on what the last one did. Blocks repeated with no stated goal and no record of the response are a process problem, not a treatment.

Why can relief last longer than the numbing medicine?

The anesthetic wears off in hours, yet relief can last for weeks. The reason is central (in the brain and spinal cord), not local. Interrupting a steady stream of pain signals lets a sensitized system turn its volume back down. That is also why the block works better when the things keeping the sensitization going are addressed at the same time. Sleep timing and metabolic terrain are the two upstream ones. The third is the posture or work load that keeps reloading the nerve. A block into an unchanged life is a shorter block.

Frequently asked questions

Does it hurt?

A brief sting. It is a small-gauge needle and a short procedure, done sitting up.

How soon will I know if it worked?

Within the first few hours for the diagnostic part. Any steroid effect builds over several days.

How many will I need?

That depends on what the first one does. There is no set course. A plan should state what counts as success before anything is repeated.

Will insurance cover it?

Coverage varies by plan. Our staff checks before scheduling. And a prior authorization is an approval to proceed, not a promise of payment.

What happens during an occipital nerve block?

Local anesthetic, usually with a corticosteroid, is placed around the greater and lesser occipital nerves at the back of the head. You sit up for it, it takes a few minutes with a small-gauge needle, and you walk out afterward. The numbing part tells us within hours whether those nerves carry your pain. Any steroid effect builds over several days.

What is an occipital nerve block used for?

It is used for occipital neuralgia, the shooting, electric pain from the base of the skull with a tender spot. It is also used for cervicogenic headache that starts in the upper neck. It serves as an add-on for chronic migraine with occipital tenderness. It helps bridge the start of a cluster bout. And it holds a floor while a medication-overuse pattern is unwound.

Who should not have an occipital nerve block?

A block is the wrong choice when the exam finds no occipital component. It is also wrong when no working diagnosis has been reached yet. That is because injecting a structure nobody has identified is how people end up with years of injections that did nothing. It also waits until anticoagulation (blood thinner) and infection risk have been reviewed. That review happens before the appointment is scheduled.

What if the occipital nerve block does not help?

That result is still useful. If the pain does not settle while the anesthetic is working, those nerves are unlikely to be carrying it. So the block rules out one suspect and points the workup somewhere else. That beats adding one more item to a long list of things to try, without learning anything from each one.

Related procedures and pages

• Occipital neuralgia
• Pain at the back of the head
• Block or medication
• Preventive options
• The first visit