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Occipital Nerve Block

Occipital Nerve Block Overview

Occipital nerve blocks are a type of therapeutic pain procedure that involves injecting a local anesthetic in the area around the occipital nerves. The occipital nerve is a branch of C2-C3 nerve roots, exiting the spinal cord and extending up to the back of the head and towards the top of the head. These nerves are often involved in migraine and other headache disorders, such as occipital neuralgia.

Occipital nerve blocks relieve headaches by blocking pain signals that the occipital nerves send to the brain.

What is occipital nerve block used for?

Occipital nerve block is used to treat occipital neuralgia and chronic headaches, such as chronic migraine. Well-described landmarks exist for injection sites to target each of these nerves. Once the provider locates the correct injection site, a designated volume of a local anesthetic, most commonly bupivacaine or lidocaine, is injected into the subcutaneous space. This is the deepest layer of your skin. You may feel relief from headache pain within 15 minutes of treatment, but this varies by individual. Others may not have relief of symptoms for a few days.

The length of time before symptoms reappear can also vary widely, lasting only days for some people but months for others. Occipital nerve block is usually not a cure for occipital neuralgia and chronic headaches, but is meant to reduce the frequency and intensity. It is often combined with other treatments for breakthrough headaches. 

Am I a good candidate for occipital nerve block?

You may be a good candidate for occipital nerve block if you have:

  • Occipital neuralgia
  • Chronic migraine
  • Cluster headache
  • Hemicrania continua
  • New daily persistent headache 

Complications from occipital nerve blocks are rare. You will experience temporary numbness over regions supplied by the occipital nerves, along with mild soreness at the injection sites for three to five days. Difficulties speaking and swallowing have been reported but only last hours at most and are very rare.

Occipital nerve block is an outpatient procedure and does not require general anesthesia.

Medically Reviewed by Kerry Knievel, DO, FAHS and Shane Root, MD on September 4, 2022