What are Occipital Nerve Blocks?
An occipital nerve block is one of the most common procedures to provide pain relief for migraines and chronic headaches. This procedure involves injecting pain-relieving medication (local anesthetic) and steroids into your greater and lesser occipital nerves. Your greater occipital nerve is responsible for most of the feeling in the back and top of your head. Irritation or inflammation of this nerve could be causing your head pain.
People with occipital nerve irritation often report pain starting from the base of their skull on one side of their head, but the symptoms can be different for everybody. The pain may extend to the temple, forehead, and behind the eyes. It may be a constant intense pain, a short but reoccurring pain, a shooting pain, or a pain with movement of the neck. There are different causes of head pain: migraines, cluster headaches, osteoarthritis of the joints in your neck (spondylosis of the cervical facet joint), or occipital neuralgia.
If you have tried other lifestyle modifications (reducing stress, regular exercise, or dietary modifications) and conservative treatment (physical therapy, anti-inflammatory, massage, or dry needling) and are still experiencing head pain as described in this blog, Dr. Kruer can work with you to see if occipital nerve blocks are a good treatment option.
A nerve block generally provides temporary relief. Patients can get up to 3 to 4 injections a year, depending on the effectiveness and your insurance coverage. Treatment plans are specific to each patient and Dr. Kruer will discuss your treatment plan with you. If a nerve block is successful in ‘blocking’ your pain then a radiofrequency ablation may be recommended to provide longer lasting relief.
What to expect with an occipital nerve block?
During the procedure, you’ll lie face down on the table. Dr. Kruer will apply an anesthetic to the back of your head just above your neck, where the nerve branch is located. He will then insert a fine needle into the injection site until the needle reaches your occipital nerve branch. When in the correct position a pain-relieving medication (local anesthetic) and a steroid (anti-inflammatory) is injected at the site.
After the injection, the area will become numb as the pain-relieving medication takes effect. Some people notice improvements in their pain in as little as 15 minutes. The procedure only takes a couple of minutes to complete. You should arrange to have someone drive you home after the procedure, but you’ll typically be able to drive and return to normal activities the next day. Please call Dr. Kruer’s orthopedic assistant if you have any questions following your procedure (406) 829-5577
Associated Risks and Pre-cautions
As with any medical procedure there are minimal risks associated. Dr. Kruer will talk to you about the risks for this procedure and answer any of your questions. Overall, research shows that occipital nerve blocks seem to be a relatively safe and effective pain management option.
Occipital injections should NOT be performed on people who have any infection or bleeding problems. The injection may slightly elevate the blood sugar levels in patients with diabetes. It may also temporarily elevate blood pressure and eye pressure for patients with glaucoma. You should discuss this with Dr. Kruer prior to receiving treatment.
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