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The injection typically consists of a local anesthetic (bupivicaine or lidocaine), with or without the addition of a corticosteroid agent (triamcinolone, methylprednisolone-depomedrol, or betamethasone).

The occipital nerve block does not require sedation or general anesthesia, so you are permitted to eat and drink beforehand. If you are taking any blood-thinning medications, be sure to notify your doctor of these drugs. In addition, discuss any allergies you have with the doctor. When you arrive for the procedure, a nurse will have you sign a consent form after discussing the risks and benefits with you. The nurse may shave a small area of hair before the injection.

The occipital nerve block only takes a few minutes to perform and involves insertion of a needle through the skin beneath the scalp. You will sit with your head bent forward and your forehead will rest on a padded table. The needle is moved in a fan-shaped pattern to block both the greater and lesser occipital nerves. The Beverly Hills pain management doctor will numb the skin with a very thin needle before inserting the block needle. Your vital signs will be monitored during the procedure, including heart rhythm, blood pressure, and oxygen level.

After the injection, you may feel warmth at the back of the scalp. In addition, you may notice that your pain is lessened for a while. We recommend that you have someone drive you home, and take it easy for a day or so. Gradually return to your normal activities as they are tolerated. Unless there are any complications, you may return to work the following day.

The most common side effect is soreness at the back of the head, where the block needle was inserted. This should disappear after a few hours. Side effects to the corticosteroids include weight gain, water retention, and elevated glucose. The nerve block is safe, but risks include bleeding, infection, and nerve damage. However, these complications rarely occur.

If you respond well to the first occipital nerve block injection, the doctor may recommend repeat injections. Usually, a series of injections is required to treat the pain. The response to the occipital nerve block varies from person to person, however.

In a recent open label follow-up trial, the success rate of the occipital nerve block was 96%, with patients reporting pain relief for six months. The duration of the pain relief increased with the number of injections given. In another study, patients reported drastically reduced headache frequency and less severity for two months following the occipital nerve block.