The greater and lesser occipital nerves come from the 2nd and 3rd cervical vertebrae, which are bones in your neck.

When these nerves become irritated, you may have headaches. You may feel pain on the back of the head or even around the eyes. This is called occipital neuralgia. A procedure called an occipital nerve block can be used to block, or “numb,” these nerves, and reduce or eliminate headaches caused by occipital neuralgia.

Occipital nerve blocks may be used to manage other painful conditions, such as:

• Migraines
• Cluster headaches
• Painful scalp
• Cervical facet arthropathy

You will have this procedure in the Northwestern Medicine Anesthesiology/Pain Medicine Clinic.

What to Expect During an Occipital Nerve Block

During the procedure:

• You will most likely sit upright or lie on your stomach on a procedure table.
• Your physician will use a very fine needle to inject a small amount of numbing medicine (local anesthetic) into the back of the head, around the occipital nerves.
• The injection may or may not include a steroid. Steroids are more commonly used when the nerve is very irritated.
• If the physician was able to place the injection very close to the nerves, your scalp on that side of the head may go numb quickly. This can lead to pain relief within minutes.

You will likely be able to drive yourself home after the procedure. You can return to normal activity the next day.

You may have pain relief almost immediately from the local anesthetic, but this may not last very long. The longer-term relief will come from the steroid, which can take several days to take effect.