Occipital nerve block is a procedure involving injection of

steroids A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and a ...

or anesthetics into regions of the

greater occipital nerve The greater occipital nerve is a nerve of the head. It is a spinal nerve, specifically the medial branch of the dorsal primary ramus of cervical spinal nerve 2. It arises from between the first and second cervical vertebrae, ascends, and then p ...

and the

lesser occipital nerve The lesser occipital nerve or small occipital nerve is a cutaneous spinal nerve. It arises from cervical spinal nerve 2, second cervical (spinal) nerve (along with the greater occipital nerve). It innervates the scalp in the lateral area of the ...

used to treat

chronic headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...

s. These nerves are located in the back of the head near in the suboccipital triangle along the line between the inion and the

mastoid process The mastoid part of the temporal bone is the posterior (back) part of the temporal bone, one of the bones of the skull. Its rough surface gives attachment to various muscles (via tendons) and it has openings for blood vessels. From its borders, t ...

. They innervate muscles in the suboccipital and posterior scalp regions. The injection will either block pain signals or reduce swelling and inflammation in these regions depending on the choice of injection. The procedure is helpful in treating

occipital neuralgia Occipital neuralgia (ON) is a painful condition affecting the posterior head in the distributions of the greater occipital nerve (GON), lesser occipital nerve (LON), third occipital nerve (TON), or a combination of the three. It is paroxysmal, la ...

and chronic headaches that arise from the neck. __TOC__

Procedure

The patient is kept conscious for the duration of the procedure. A small gauge needle is inserted at points of the greater and lesser occipital nerves down to the periosteum of the occiput. Some pain may be felt during the insertion of the needle through the skin. Injected anesthetics give pain relief almost immediately while steroid injections take 3–5 days to provide relief. The procedure has no major common complications, but some uncommon risks include bleeding, especially if on blood thinning medication, infection, and nerve damage.

Studies

In 2018, the ''

Journal of the American Board of Family Medicine The ''Journal of the American Board of Family Medicine'' is the official publication of the American Board of Family Medicine. It was formerly published as ''The Journal of the American Board of Family Practice'' by the Board of the Massachusetts ...

'' has carried out a study to examine the efficacity of occipital nerve block in mitigating

migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...

. The experimentation was done on 592 patients who had migraines and when they underwent greater occipital nerve block, 82% of them reported significant reduction of the pain. Though, the study was revealed possibilities to conclude its usage as effective, some parts of the medical community expressed that the test needs to be carried out on greater sample space before remarking anything conclusive.

Notes

{{Reflist Headaches Regional anesthesia