From the Guidelines
The primary purpose of an occipital nerve block service is to provide short-term treatment of migraine, as suggested by the 2024 clinical practice guideline for the management of headache 1. The procedure involves injecting anesthetic medication around the greater and lesser occipital nerves at the base of the skull, typically a mixture of a local anesthetic and sometimes a corticosteroid to reduce inflammation.
- The injection is administered in the scalp near the occipital region where these nerves emerge.
- Patients usually receive this treatment in an outpatient setting, and the procedure takes only minutes to perform.
- Relief can be immediate and may last from several days to months depending on the individual and whether steroids were included. This treatment works by temporarily blocking pain signals transmitted by the occipital nerves, which can become irritated or compressed due to muscle tension, injury, or other conditions like occipital neuralgia.
- The block not only provides diagnostic information about the source of pain but also offers therapeutic benefits by interrupting the pain cycle and reducing nerve inflammation. However, it is essential to note that there is insufficient evidence to recommend for or against greater occipital nerve block for the prevention of chronic migraine 1. Patients should be aware that temporary numbness in the scalp is normal after the procedure, and they may need multiple treatments for sustained relief, as the current evidence only supports its use for short-term treatment of migraine 1.
From the Research
Occipital Nerve Block Service
The occipital nerve block service is a treatment method used to manage various types of headaches, including:
- Occipital neuralgia
- Cervicogenic headache
- Cluster headache
- Migraine
- Tension headache
Purpose of the Service
The primary purpose of an occipital nerve block service is to provide relief from chronic headaches by:
- Temporarily numbing the occipital nerves
- Reducing inflammation around the occipital nerves
- Diagnosing and treating occipital neuralgia
Procedure and Effectiveness
The procedure involves injecting a local anesthetic and possibly a corticosteroid near the occipital nerves at the base of the skull 2, 3, 4. The effectiveness of the service has been demonstrated in various studies, with satisfactory results reported in up to 95.45% of patients 2. The service has also been shown to be safe, with minimal side effects associated with the injection process 4.
Indications and Selection Criteria
The service is indicated for patients with chronic headaches who have not responded to medication or other treatments 3, 5. Selection criteria for the service may include tenderness over the greater occipital and lesser occipital nerves, as well as reproduction of headache pain with occipital nerve pressure 3, 6.
Treatment Options
In addition to occipital nerve blocks, other treatment options for occipital neuralgia may include: