Occipital Nerve Block

What is an occipital nerve block?

Occipital nerve block is a medical procedure that involves administration of a dose of medication into an area in the back of your head. It is most frequently used to diagnose and treat a type of tension headache most likely due to occipital neuralgia or an irritation of a nerve in the back of one’s head. This treatment has brought relief to many patients who suffer from pain caused by occipital tension headaches.

How quickly can I expect pain relief?

Pain relief is usually felt fairly quickly after the injection of medication. If your doctor uses a local anesthetic followed by a steroid type of medication, you can expect to feel some initial pain relief that may then dissipate when the local anesthetic has worn off (several hours later). You can expect to feel some additional pain relief roughly 48 hours later when the steroid medication begins to take effect.

How should I prepare for the procedure?

The occipital nerve block is a safe medical procedure but, as with any procedure, it has risks as well as benefits. To minimize the chance of complications, we ask that you follow a few simple guidelines:
Do not eat or drink anything for 6 hours prior to the procedure.
We require that you be accompanied to and from API by a responsible adult driver. Most likely you will be offered a small dose of intravenous medication during the procedure which will act to not only decrease anxiety, but provide you some pain relief from the minor discomfort of the procedure itself. This intravenous medication will also impair your driving ability.

What happens during the procedure?

First, an intravenous line will be placed, generally in your hand. We will then bring you to the operating room and place several monitors on you, such as a heart, blood pressure and a pulse monitor. These will enable us to monitor your vital signs throughout the procedure. Following placement of the monitors we will begin to give you some intravenous medication in order to decrease anxiety, as well as provide you with some pain relief.
You will then be asked to sit on the side of the bed. After cleaning a small patch of your skin, a local anesthetic will be injected into the skin to decrease any pain associated with performance of the procedure. The medication is then administered through a small needle in the occipital region of your head and neck. The procedure itself is very brief, and usually lasts less than 10 minutes. Occasionally, patients describe a transient worsening of their headache after the medication is administered. This is viewed by the physicians as a reassuring sign that the medication is going into the right area, and this sensation should disappear very quickly.

What happens after the procedure?

After the occipital nerve block is performed, we will continue to monitor you in the recovery room for 30 to 40 minutes. If there are no signs of any problems, you will be ready to leave. If you have any questions after your procedure, the medical staff of the Advanced Pain Institute is on call 24 hours a day, 7 days a week. You can reach either a nurse or physician by calling (626) 445-2371.

Will my insurance cover the procedure?

The occipital nerve block is a well established medical procedure and is reimbursed by most insurance companies. Any need for preauthorization of services or copayments, depends on your insurance carrier. Our office staff will assist you in obtaining preauthorization whenever possible.

What should I expect from this procedure?

Occasionally, patients will describe a transient worsening of their headache as the injection is made. This is viewed by the physicians as a reassuring sign that the medication is going to the right place, and the sensation usually disappears very quickly. This should then be followed by a pain free interval of several hours. After the local anesthetic has worn off, your headache may return for up to 1-1/2 days. After this time, the steroid medication that was also injected for your occipital nerve block should begin to work and provide you with further pain relief.

What possible side effects might I see?

As stated above, after the local anesthetic that was injected as part of your occipital nerve block wears off, your headache may return for roughly 24 to 36 hours. After this time, you should receive some pain relief from the medication that was also injected during the time of your occipital nerve block. You may also experience some slight soreness at the site of the injection. This is very normal, and should go away within a couple of days.

What should I do if any problems develop after I leave the hospital?

If you have any questions after the procedure, the medical staff of the Advanced Pain Institute is on call 24 hours a day, 7 days a week. You can reach either the nurse or physician by calling (626) 445-2371.
Post procedure instructions
These will be provided for you, in further detail, by the recovery room nurse, prior to your discharge from the Ambulatory Surgery Center. These instructions should include: no driving or operating heavy machinery for 24 hours after the procedure. This is recommended due to the fact that you have received intravenous medication during a procedure which may impair your ability to perform these tasks.