Occipital Nerve Block
Using ultrasound for guidance, injections are made to the back of the head, just above the neck. Pain concentrated at the back of the head, including certain types of tension headaches and migraine headaches, often respond to this treatment.
During the Procedure
This is procedure only takes a few minutes. The injected steroid reduces any inflammation and swelling of tissue around the occipital nerves. That inflammation is frequently the root cause of a patient’s head pain.
Discomfort during the procedure should be minimal since the injection site is numbed with a local anesthetic using a very thin needle during the performance of the block. Afterward, the patient rests briefly in the office. Most people can drive themselves home, but should take it easy and not return to work or other taxing activities until the next day.
If a patient desires further sedation, that is certainly available. Usually this isn’t necessary and sedation does increase recovery time. Also a patient must then be driven home by a second party.
Patients are advised to be aware that after the injection, pain may seem to be gone; this is due to the anesthetic and will only last for a few hours. Unfortunately, the original pain will likely return in addition to a sore head for a day or two. The good news is that after three to five days, longer-term pain relief is possible.
Degrees of response vary widely. For those patients who do not have success with the first occipital nerve block, subsequent injections may or may not be advisable. Although Dr. Dumitru recommends the procedure only when it seems likely that inflamed tissues around the occipital nerves are causing a patient’s pain, the first injection is essentially a test. If a patient experiences at least some degree of relief, that is confirmation that the occipital nerves are the culprit for their pain and more injections will likely help.
Additional nerve blocks are usually performed about a week apart as needed, but Dr. Dumitru does not conduct more than three in a six-month period. If pain returns before six months are up, alternate treatments are pursued.