For Headaches

A greater occipital nerve block is an outpatient procedure for treating headaches. The greator occipital nerve (GON) and/or the lessor occipital nerves (LON) can be involved. This information sheet will explain what it is. Your doctor can explain if it is for you.

What are the occipital nerves?

The greater and lessor occipital nerves are located in the back of your head. They produce tenderness and headache at the base of your head. These nerves can be irritated from trauma or chronic upper neck pain.

What is occipital nerve pain?

You may feel a headache if the greater or lessor occipital nerves are irritated. Sometimes it feels like muscle tension in the head. But at other times the pain may be severe and feels like a migraine. Unlike a migraine, occipital nerve pain does not respond to migraine medication. However, it does decrease with a GON and/or LON block.

How do I know if I have occipital nerve pain?

If you have chronic upper neck pain or headaches you may have occipital nerve pain. A GON and/or LON block is the best was to determine this.

What is an occipital nerve block?

In an occipital nerve block, a local anesthetic (numbing medicine) and a corticosteroid (an anti-inflammatory medicine) are injected near the GON and/or LON. The anesthetic helps to temporarily numb pain, and the steroid helps reduce inflammation. This injection can be used to diagnose or treat your pain. Your doctor will determine which nerve is causing your headaches.

What happens during an occipital nerve block?

The doctor will insert a small needle near the greater occipital and/ or lessor occipital nerve (into the scalp at the base of the skull). When

the doctor is sure the needle is at the correct place, the medicine will be injected.

What happens after an occipital nerve block?

You will be monitored for up to 15 minutes after the injection. When you are ready to leave, the clinic will give you discharge instructions and a pain diary. It is important to fill out the pain diary because it helps your doctor know how the injection is working.

You may feel immediate pain relief and numbness in the back of your head for up to six hours after the injection. This tells you the medication has reached the right spot.

Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal. It may be caused by needle irritation or by the corticosteroid itself. Corticosteroids usually take two or three days to start working, but can take as long as a week.

You can usually return to work the day after the injection, but always check with your doctor.

How long can I expect pain relief?

How long you can expect pain relief depends on how many areas are injured, and on the amount of inflammation.

Sometimes an injection can bring several months of pain relief, and then more treatment is needed. Other times, particularly if there is no underlying muscle or joint problem, one injection brings long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by one injection.