Illustration · Where it worksOccipital Nerve Block
An injection at the back of the head that calms irritated occipital nerves to ease and diagnose headaches.
An occipital nerve block is an injection of numbing medicine, often with a small dose of steroid, near the occipital nerves at the back of the head. It can ease headaches that start at the base of the skull and help show whether those nerves are part of the problem. Dr. Patel uses it as one part of a plan that also looks at the neck, posture and headache triggers.
- TypeNerve blocks
- GuidanceAnatomical landmarks, with ultrasound guidance when helpful
- Also calledGreater occipital nerve block, GON block
Is it right for you?
A consultation with Dr. Patel confirms whether this treatment is the right fit.
How it works
The greater and lesser occipital nerves start in the upper neck, around the C2 and C3 levels. They run up through the muscles at the base of the skull and spread across the scalp. When they become irritated, pain can begin at the base of the skull and travel around the side of the head toward the forehead, and sometimes behind the eye. Doctors call this pattern occipital neuralgia.
An occipital nerve block places a local anesthetic, often with a corticosteroid, next to these nerves. The anesthetic quiets their signals for a few hours. The steroid may calm irritation over the following days. In the brainstem and upper spinal cord, signals from the occipital nerves meet pain pathways from the face and forehead. That is why a block can sometimes ease migraine and cluster headaches even when these nerves are not the original cause.
The block is also a diagnostic tool. Headache can come from the nerves, the joints of the upper neck, the muscles or the brain’s own pain networks, and these can be hard to tell apart. If your usual headache eases while the nerve is numb, that points toward the occipital nerves. Dr. Patel may block the greater and lesser occipital nerves separately to narrow the source further and plan more targeted treatment.
The injection is minimally invasive and quick. It is not a cure, and relief varies from person to person. For some people it lasts days, for others weeks or longer, and for some it does not help. Dr. Patel pairs it with physical medicine: neck mobility work, posture and workstation changes, a review of sleep and headache triggers, and medication management that does not rely on opioids.
Your appointment, step by step
The injection itself takes a few minutes, and most visits last about 15 to 30 minutes including a short rest.
Review and consent
Dr. Patel reviews your headache history, examines your neck and scalp, and explains the injection. You can ask questions before giving consent. Tell the team about blood thinners, diabetes, allergies or any past reaction to steroids.
Positioning
You sit leaning forward or lie face down. The hair is parted, not usually shaved, and the skin at the back of the head is cleaned with antiseptic.
Finding the nerve
Dr. Patel locates the nerve by feeling for landmarks such as the pulse of the occipital artery, which runs beside the greater occipital nerve. Ultrasound may be used to see the nerve and nearby blood vessels.
The injection
A very thin needle delivers the medicine near the nerve. You may feel a brief sting and some pressure. One or both sides may be treated, and the lesser occipital nerve may be blocked as well.
Short rest
You rest for a few minutes while the team checks how you feel. The back of your scalp will often feel numb. You will be asked to rate your headache before you leave.
Going home
Most people go home soon after and resume light activity the same day. A simple headache diary over the next two weeks helps Dr. Patel judge how well the block worked.
After the procedure · Honest risks
- The back of the scalp often feels numb for a few hours as the anesthetic wears off.
- Mild soreness or tenderness at the injection site can last a day or two.
- If a steroid is used, its effect usually begins within a few days.
- Most people return to normal daily activity the same day or the next day.
- Relief varies: some people feel better for days, others for weeks or longer.
- If the block helps, it may be repeated, spaced out to limit total steroid exposure.
- Dr. Patel reviews your headache diary at follow-up to plan next steps.
- Soreness, bruising or brief bleeding at the injection site
- Lightheadedness or fainting during or shortly after the injection
- A temporary flare of headache before any improvement
- Steroid effects such as facial flushing, trouble sleeping or a short rise in blood sugar for people with diabetes
- Uncommonly, a small patch of hair loss or thinning of the skin at the injection site, linked to the steroid
- Rarely, infection, an allergic reaction or injection into a blood vessel
Questions
Does an occipital nerve block hurt?
How long does the relief last?
Can it help migraines if my occipital nerves are not damaged?
Will my hair need to be shaved?
How often can the block be repeated?
This page explains a condition or treatment in general. It is not a diagnosis or medical advice for you. Dr. Patel will explain what applies to you at your visit.
Treatments
Selective Nerve Root Block
A precise injection at one spinal nerve root to find and treat the source of arm or leg pain.
Nerve Blocks
Numbing medicine placed at specific nerves to find a pain source and, in many cases, ease the pain.
Stellate Ganglion Block
An injection at the base of the neck that blocks sympathetic nerves to the face, neck, upper chest and arm.