An occipital nerve block involves injecting the top aspect of the neck with a long-acting anesthetic. This is done to provide pain relief for occipital neuralgia and various types of headache pain. With the occipital nerve block, pain relief lasts for months, and the frequency of headaches decreases.
The occipital nerves run along both sides of the head at the back of the neck. These include one pair of greater occipital nerves and one pair of lesser occipital nerves. All four of these nerves provide sensation to the posterior region of the head, and they do not have any motor function. When inflamed or irritated, these nerves can cause bad headaches the usually are perceived on one side of the head.
The occipital nerve block is used for numerous types of headaches. This block also reduces the pain from occipital neuralgia, migraine headaches, cluster headaches, and cervicogenic headaches. Not only does this block help with the pain associated with these headaches, it reduces the frequency of occurrence.
If you are taking a blood-thinning agent, hold it for 5-7 days before the procedure. Be sure to talk to your pain management specialist about all your medications, so he/she can advise you of which ones could interfere with the procedure. When you arrive at the medical facility, a nurse will go over the risks and benefits with you and have you sign a form of informed consent.
The doctor does the block in his/her office procedure room. The pain management specialist will cleanse the scalp with an antiseptic solution, and numb the area with a local anesthetic. The injection needle is inserted near the occipital nerves and several injections are made to provide the blocking effect. For long-lasting pain relief, the doctor may use a neurolytic agent, such as phenol.
The occipital nerve block is extremely effective for providing headache relief. One clinical study found a success rate of 95% for cervicogenic headache, with pain relief lasting for up to six months. For cluster headache, studies show the efficacy rate to be around 85%, which lasts for 1-4 months. The numbers for migraine headache and occipital neuralgia are encouraging, as well. These blocks show an 85% success rate for these headaches, with effects lasting for up to six months.
One method of treating headaches and occipital neuralgia similar to the occipital block is the occipital radiofrequency ablation. The pain specialist uses pulsed radiofrequency ablation to destroy a portion of the occipital nerve root, thus eliminating pain signal transmission. This procedure is quite effective with over half of study participants enjoying more than 50% pain relief, according to clinical studies.
This procedure has a very low risk profile. However, complications include infection, bleeding, and nerve injury. The occipital nerves are located behind the spinal canal, so there is little danger of puncture to the spinal cord.