Occipital nerve block
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1 Occipital nerve block Humphrey Booth Building Neurosciences All Rights Reserved Document for issue as handout.
2 Occipital nerve blocks can be effective at treating some forms of headache and localised scalp pain / tenderness. They can be used in combination with, or instead of oral treatments. What is an Occipital Nerve Block? An occipital nerve block is an injection of local anaesthetic next to the occipital nerves, which lie just beneath the skin at the back of the head. Since these nerves are outside the skull, they are easy to locate. How does it work? The occipital nerves carry sensation messages from the scalp at the back of the head (the occipital area). In migraine and some other headache types, these nerves can become hypersensitive to pain. Messages from these nerves feed in to the part of the brain which is overactive in migraine. Temporarily blocking these messages with local anaesthetic can reduce the over activity and reduce head pain. The treatment does not cure your condition, but it may lessen the pain for several days, weeks, or months. How long does the injection take?? The actual injection takes only 5-10 minutes to administer. What is actually injected? The injection usually consists of a local anaesthetic (similar to what your dentist would use). Occasionally a steroid (anti-inflammatory) medication may be added to the local anaesthetic. The nerve blocks are relatively simple to perform. Your doctor will use a small needle to inject the medication into the area around the nerves at the back of the head. Will the injection hurt? Insertion of the needle is not especially painful, but as the medication is injected, some patients may feel mild temporary discomfort or stinging sensation. Once the Occipital nerve block is completed, pain relief can happen rapidly, sometimes within a few minutes of the block and can last from days to months. 1 2
3 How is the injection performed? What should I expect after the injection? The procedure is usually performed in a regular examination room and does not require any preparation on the patient s part. You will be asked to sit on a couch or chair with your head bent forward. Your doctor will use a small needle to inject a solution into the area around the nerves. Immediately after the injection the back of your head may feel warm. You may also notice that your pain has gone or lessened considerably. Can I return to normal activities? Absolutely. You should have no problem driving afterwards and may carry on with your day as you would otherwise. How long will the effects of the medication last? The local anaesthetic wears off in a few hours, but the effect on headache relief can last days, weeks or (rarely) months Will the occipital block help me? It is not possible to predict if the injection(s) will help you or not. In our experience, of the patient s that we select for injection therapy, about 50% will notice some improvement in symptoms. What are the risks and side effects? This procedure is generally safe. However, like with any procedure there are risks, side effects and the possibility of complications. The most common side effect is mild discomfort - which is temporary. Since the scalp has many tiny blood vessels near the surface of the skin, some bleeding from the injection site may occur. Fortunately, the serious side effects and complications are uncommon. Because these are sensory nerves, you may experience some temporary numbness over the regions supplied by the nerves. In exceptionally rare circumstances, patients have reported a small patch of hair loss around the injection site when steroid has been used. Who should NOT have this injection? If you are allergic to any of the medications to be injected, if you are on blood thinning medications (e.g. warfarin), if you have an active infection going on near the injection site. 3 4
4 Notes Notes 5 6
5 G W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2018 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: NOE05(18) Review Date: March 2020 For further information on this leaflet, it s references and sources used, please contact Copies of this leaflet are available in other formats (for example, large print or easyread) upon request. Alternative formats may also be available via www. srft.nhs.uk/for-patients/patient-leaflets/ If you need this information leaflet translated, please telephone: In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities to access this service. Please contact the service/clinic you are attending by phone or prior to your appointment to discuss your requirements. Interpreters are available for both verbal and non-verbal (e.g. British Sign Language) languages, on request. Please contact the service/clinic you are visiting to request this. or InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on This is a teaching hospital which plays an important role in the training of future doctors. The part patients play in this process is essential to make sure that we produce the right quality doctors for all of our futures. If at any time you would prefer not to have students present please inform the doctor or nurses and this will not affect your care in anyway. Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients
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