Occipital Nerve Block

What is occipital nerve block?

Occipital nerve block is numbing of the greater and lesser occipital nerve. The block is an injection composed of an anesthetic and a corticosteroid next to the greater and lesser occipital nerves, which are located just beneath the scalp, superficial to the skull, in the back of the head. It is most often used in the diagnosis and treatment of occipital neuralgia and cervicogenic headache.

Who is a good candidate for occipital nerve block?

Chronic headache sufferers who have failed to find persistent relief with pain medication or other therapies are often good candidates for occipital nerve block. Typically, these patients suffer from the following types of headaches:

  • Chronic and episodic migraines
  • Chronic and episodic cluster headaches
  • Tension-type headaches
  • Occipital neuralgia
  • Cervicogenic headache


As mentioned above, occipital nerve block is often used to treat occipital neuralgia and cervicogenic headache. Most patients with cervicogenic headaches have associated spondylosis or problems of the cervical facet joints in the neck, and therefore, may need an additional block in the cervical facet joint to completely alleviate their symptoms.

How occipital nerve block works

The procedure involves inserting a small fine needle through the skin beneath the scalp in order to get the anesthetic and corticosteroids around the area of the nerve. In order to minimize this discomfort, your pain specialist may numb the skin in the injection area with an even smaller needle with a local anesthetic before inserting the block needle. The injection blocks both the greater and lesser occipital nerves.

Typically, if you respond well to the injection and have pain relief, then it is recommended that you return and receive repeat injections. Usually, a series of block injections are needed to treat the problem adequately, however, the response to the block varies from patient to patient. Also, if you respond well to the occipital nerve block then you will most likely benefit even more with the addition of occipital nerve stimulation.

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