Greater Occipital Nerve
The greater occipital nerve is found between the first and second cervical vertebrae, along with the lesser occipital nerve. The greater occipital nerve supplies sensation to the skin along the back of the scalp to the top of the head. When the occipital nerve becomes irritated, the pain can sometimes be felt near the eye of the same side of the head (known as referred pain). People with occipital nerve irritation often report pain starting from the base of their skull on one side of their head. The pain may extend as far as the temple, forehead, and behind the eyes.
Occipital Nerve Block
During a nerve block, pain-relieving medicine is injected to the region where the nerve crosses the skull. The patient is usually lying on his or her stomach. The needle is placed near the nerve and the anesthetic (or a combination of anesthetic and steroid) are injected. Pain relief may be immediate and usually lasts as long as the numbness, sometimes the relief may be long lasting.
An occipital nerve block is done to manage:
Migraines. Migraines are a neurological condition that usually causes intense headaches on one side of the head. People who have migraines commonly also experience nausea, dizziness, and mood changes.
Cluster headaches. Cluster headaches are a short but painful series of reoccurring headaches. People who experience them tend to get them seasonally.
Spondylosis of the cervical facet joints. Also called osteoarthritis of the joints in your neck, spondylosis of the cervical facet joints is often caused by the age-related breakdown of your neck bones and discs.
Occipital neuralgia. Occipital neuralgia is a headache disorder that usually causes shooting pain in the back of your head, one side of your neck, and behind your ears. Pain is caused by damage to the greater and lesser occipital nerves.
A tender or painful scalp, which may be a sign of an inflamed nerve
In a 2018 study, researchers looked at the effectiveness of greater occipital nerve blocks for treating migraine pain. The study looked at a total of 562 patients over a 5-year period. More than 82 percent of participants in the study reported having moderate or significant pain relief from the treatment.
A 2018 review of studies published in the journal Clinical Neurology and Neuroscience also concluded that occipital nerve blocks can significantly reduce pain intensity for people with migraines.
Occipital Nerve Block Procedure
During an occipital nerve block, about a teaspoon of local anesthetic and steroids are injected into the scalp where the trunk of the nerve is. The injection is done at the back of the head, just above the neck. The skin is numbed before the injection is done.
This injection will cause the scalp on that side of the head will go numb quickly. Pain relief can be felt sometimes within minutes. If there is swelling within the nerve the anti-inflammatory properties of the steroids will continue to work for the next several days to relieve inflammation.
The procedure itself takes fifteen minutes or less and patients can usually drive home and return to normal daily activities the following day. The effects of the local anesthetic may wear off in a few hours, but the effects of the steroid begin to increase over the next several days.