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Occipital Nerve Block

The occipital nerve block is an injection used to treat pain of the head and scalp. This block can be either a diagnostic tool or a treatment.  The occipital nerve block provides anesthesia to reduce and relieve pain in the back of the head. Conditions treated include occipital neuralgia and various types of headaches such as migraines.

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The injection typically consists of a local anesthetic (bupivicaine or lidocaine), with or without the addition of a corticosteroid agent (triamcinolone, methylprednisolone-depomedrol, or betamethasone).
The occipital nerve block does not require sedation or general anesthesia, so you are permitted to eat and drink beforehand. If you are taking any blood-thinning medications, be sure to notify your doctor of these drugs. In addition, discuss any allergies you have with the doctor. When you arrive for the procedure, a nurse will have you sign a consent form after discussing the risks and benefits with you. The nurse may shave a small area of hair before the injection.
After the injection, you may feel warmth at the back of the scalp. In addition, you may notice that your pain is lessened for a while. We recommend that you have someone drive you home, and take it easy for a day or so. Gradually return to your normal activities as they are tolerated. Unless there are any complications, you may return to work the following day.
In a recent open-label follow-up trial, the success rate of the occipital nerve block was 96%, with patients reporting pain relief for six months. The duration of the pain relief increased with the number of injections given. In another study, patients reported drastically reduced headache frequency and less severity for two months following the occipital nerve block.