Occipital nerve block is a procedure involving injection of

steroids A steroid is an organic compound with four fused rings (designated A, B, C, and D) arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter mem ...

anesthetics An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into tw ...

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 pa ...

and the

lesser occipital nerve The lesser occipital nerve (or small occipital nerve) is a cutaneous spinal nerve of the cervical plexus. It arises from second cervical (spinal) nerve (C2) (along with the greater occipital nerve). It innervates the skin of the back of the up ...

used to treat chronic headaches. These nerves are located in the back of the head near in the

suboccipital triangle The suboccipital triangle is a region of the neck bounded by the following three muscles of the suboccipital group of muscles: * Rectus capitis posterior major - above and medially * Obliquus capitis superior - above and laterally * Obliquus capit ...

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 The scalp is the area of the head where head hair grows. It is made up of skin, layers of connective and fibrous tissues, and the membrane of the skull. Anatomically, the scalp is part of the epicranium, a collection of structures covering th ...

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, l ...

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 The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. (At the joints of long bones the bone's outer surface is lined with "articular cartila ...

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

migraine Migraine (, ) is a complex neurological disorder characterized by episodes of moderate-to-severe headache, most often unilateral and generally associated with nausea, and light and sound sensitivity. Other characterizing symptoms may includ ...

. 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