Sometimes headaches are unbearable, aren't they? Only those who suffer from them know the pain that comes with them, especially when the pain starts in the back of the neck and spreads throughout the head, making it feel like your eyes are going to pop out. Do you also feel like there is no relief from this, no matter how much medicine you take or what you do? If you are also suffering from this problem, your doctor may have told you about a treatment called 'Occipital Nerve Block'. Although the name may sound a little scary, it is actually not that big of a deal. So let's talk about this in a simple and clear way today.
Simply put, what is this Occipital Nerve Block?
An Occipital Nerve Block is an injection that is given near the occipital nerves at the back of your head. It's like a numbing medicine given to your gums before a tooth extraction. The injection temporarily numbs the nerves and the surrounding tissue. It's usually done with an anesthetic . Sometimes, a steroid is added to reduce inflammation in the nerves.
This is not a major surgery. It just temporarily controls the pain and gives the nerve a chance to heal.
Where are these occipital nerves located?
These occipital nerves originate from the spinal vertebrae (C2 and C3) at the top of your neck. They provide sensation mainly to the skin and skull at the back of your head. There are three types of these nerves on each side of our head.
| Nerve Type | The area that provides sensation |
|---|---|
| Greater Occipital Nerve (GON) | The largest of the three nerves, it provides sensation from the back of the head to the top of the head, to the ears and the skin above the ears. |
| Lesser Occipital Nerve (LON) | It provides sensation to the back of the skull and the outer skin of the earlobe. |
| Third Occipital Nerve (TON) | It provides sensation to the skin in the lower middle part of the back of the head. This nerve can be damaged in whiplash, such as in a car accident. |
Imagine, when something goes wrong with these nerves, the pain is felt not only in the back of the neck. Sometimes the pain can also come from places like the eyes and forehead. Doctors call this 'referred pain'. That means the problem is in one place, but the pain is felt in another place.
What conditions is this treatment used for?
Doctors usually recommend this Occipital Nerve Block for severe headaches that are difficult to control with other treatments.
- Occipital Neuralgia: This is the main cause. It is a sharp, electric-like pain caused by compression or damage to the occipital nerve.
- Migraine headaches
- Cluster headache
- Cervicogenic headache: Headache caused by problems with the vertebrae in the neck.
- Postdural puncture headache
- Neck pain: Pain felt especially in the upper, back part of the neck.
- Neck injuries from an accident (Whiplash)
Sometimes, your doctor may use this nerve block for diagnostic purposes to find the exact cause of your pain. Imagine, if your pain goes away after this injection, it confirms that the problem is in the occipital nerve. Then it is easier to plan the right long-term treatment for it.
How should you prepare for this?
This usually doesn't require much preparation. It's a simple procedure done in the outpatient department.
However, sometimes your doctor may decide to give you a sedative to keep you calm and make you feel a little drowsy. If they do, they will tell you not to eat or drink anything for 6 to 8 hours. Also, you will need to bring someone to drive you home because you will not be able to drive that day. Your doctor will explain all of this to you in advance. So don't be afraid to ask him or her any questions you may have.
What happens during treatment?
This process is very quick, taking no more than 5 minutes.
1. First, you will be asked to sit in a chair and have your head slightly lowered. Or, you will be asked to lie on your stomach on a bed with a pillow under your chest so that your neck is slightly bent.
2. If you are being sedated, a cannula is inserted into a vein in your arm and some medicine is given through it.
3. The doctor will then feel the back of your neck to find the exact location of the nerve. Sometimes, a scan (ultrasound or fluoroscopy) may be used to find the exact location.
4. The injection site is thoroughly cleaned with a disinfectant solution.
5. Then, the medicine is injected near the identified nerve with a very fine needle.
6. You will be asked to rest for a few minutes after the injection.
That's all that happens. There's nothing to be afraid of.
What happens after the injection?
If you were given a sedative, you will be monitored by a nurse for about 15-30 minutes. This will be to see if anything unusual happens. After that, you can go home. If you were not given a sedative, you can leave after about 10 minutes.
Side effects and results
Although this treatment is very safe, as with any medical procedure, minor complications can occur.
- Common side effects: There may be some mild pain, redness, or swelling at the injection site for two to three days. This is normal. Some people may also feel a little dizzy or nauseous.
- Steroids: If you use a steroid medicine, you may experience thinning of the skin around the injection site (atrophy) or temporary hair loss (alopecia). These are very rare.
- Rare risks: Bleeding, infection, nerve damage, and transient dysphagia are very rare.
How long does this pain relief last?
Here's the important thing. The results vary greatly from person to person . Some people experience significant pain relief within 20-30 minutes of the injection, and the relief lasts for months. Others only experience relief for a few hours or days. Sometimes, there are people who experience no relief at all.
For conditions such as Occipital Neuralgia and Cervicogenic headache, you may need to receive a series of injections to achieve permanent relief. This will all be determined by your doctor based on your condition.
When should you call the doctor?
When you go home after treatment, be aware of these things.
- If the injection site becomes severely swollen, red, oozing pus , or has a fever (these may be signs of an infection).
- If the pain increases instead of decreasing.
- If you feel a new burning pain, numbness or weakness in your limbs.
If you develop any new symptoms like these, call your doctor right away. Don't panic, but it's important to be informed.
Take-Home Message
- An Occipital Nerve Block is an injection near a nerve used to treat severe headaches and neck pain, not a major surgery.
- This not only relieves the pain, but also helps diagnose the exact cause of the pain.
- Results vary from person to person. Some people may experience months of relief, while others may not see much improvement.
- This is generally a very safe treatment, but there may be minor side effects, such as slight pain and swelling at the injection site.
- If you have any fears or doubts about this treatment, talk to your doctor about it openly. He or she will explain everything to you.
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