What is an Occipital Nerve Block?

An Occipital Nerve Block is an injection used to treat pain originating from the greater
and/or lesser occipital nerves, which are located at the back of the head. These nerves can
become irritated or inflamed, causing headaches or scalp pain. The procedure involves
injecting local anaesthetic, often combined with a steroid, near these nerves to relieve
inflammation and block pain signals.

Conditions Treated

  • Occipital neuralgia (sharp, stabbing pain at the back of the head)
  • Chronic migraine or cluster headaches with a significant occipital component
  • Post-traumatic or post-surgical headache
  • Scalp pain or sensitivity that has not responded to other treatments
  • Headaches due to cervical spine problems
 

Why is it done?

This procedure is carried out to:

  • Provide targeted headache and scalp pain relief
  • Help confirm whether the occipital nerves are the source of pain (diagnostic value)
  • Reduce reliance on oral medications, especially opioids or triptans
  • Improve sleep, concentration, and quality of life
  • Assess suitability for further treatments (e.g. pulsed radiofrequency)

Very Common side effects

(may affect more than 1in 10 patients):
  • Pain or bruising at the injection site
  • Numbness or tingling over the back of the head
  • Temporary increase in headache before relief

Common side effects

(may affect up to 1in 10 patients):
  • Dizziness or light-headedness
  • Mild facial flushing or nausea

Uncommon side effects

(may affect up to 1in 100 patients):
  • Infection at the injection site
  • Temporary neck stiffness or local muscle spasm

 

Rare side effects

(may affect up to 1in 1,000 patients):
  • Nerve injury or prolonged numbness
  • Bleeding or haematoma
  • Allergic reaction to the anaesthetic or steroid

What does the procedure involve?

  • You will be seated or lie face down comfortably.
  • The back of your head will be cleaned and numbed with local anaesthetic.
  • Using palpation or ultrasound guidance, a fine needle is inserted near the greater and/or lesser occipital nerves.
  • A small volume of local anaesthetic, with or without steroid, is injected.
  • The procedure usually takes 10–20 minutes and is done as a day case.

Benefits

  • Quick and effective pain relief from occipital nerve-related headaches
  • Reduced need for regular oral medications
  • Improved ability to function, rest, and participate in daily life
  • Diagnostic clarity to guide further treatment (e.g. pulsed RF)
 

Aftercare Advice

  • You will be monitored briefly and usually discharged the same day.
  • Avoid driving for 24 hours.
  • Mild numbness, tingling, or soreness at the back of the head is common and usually resolves within hours.
  • Use simple painkillers or cold packs if needed.
  • A follow-up appointment may be arranged to assess the outcome and consider further options if required.

When to Seek Medical Attention

Please attend A&E immediately if you experience:
• Fever, chills, or redness/swelling at the injection site
• New or worsening numbness, weakness, or visual symptoms
• Loss of balance or coordination
• Severe or persistent headache not relieved by usual medication