A Great Treatment for Migraines – Occipital Nerve Blocks

Occipital Nerve Block in Colorado


The occipital nerve block is a form of treatment for various headache syndromes. The occipital nerves are located at the back of the head, right above the neck region. Injecting these nerves will stop pain signal transmission to the brain.

What are the occipital nerves?

The occipital nerves are two pairs of nerves that originate near the 2nd and 3rd cervical (neck) vertebrae. These nerves start at the base of the skull (neck nape) and spread to the scalp behind the eyes, and on the front, side, and back of the head.

What conditions are treated using the occipital nerve block?

The occipital nerve block is used to treat:

  • Occipital neuralgia – This condition has a 1% prevalence rate.
  • Chronic migraine – Migraine headaches affect around 10% of the general adult population.
  • Cervicogenic headache – These headaches affect around 4% of U.S. adults.
  • Cluster headache – This syndrome affects 2-3% of the general population.
  • Chronic daily headache – This affects around 2-3% of Americans.

What is the purpose of the occipital nerve block?

The corticosteroid injected onto the nerves reduce swelling and inflammation of the tissue around the occipital nerves. The anesthetic will reduce pain and nerve irritation, blocking pain signal transmission. The occipital nerve block is used to treat various pain disorders of the neck and head.

How do I prepare for the occipital nerve block?

Before you have the block, you will first meet with the Colorado pain management specialist. The pain doctor in Boulder, Loveland, Aurora, Greeley, Longmont or Colorado Springs will inquire about your medications, as certain blood thinning drugs are to be held for a few days before the injection. The doctor will take a medical history and conduct a physical examination. After scheduling the procedure, the doctor or nurse reviews risks and benefits and has you sign a consent form.

How is the occipital nerve block performed?

The doctor uses a small thin needle to numb the region beforehand in most cases. You are placed face-down on the table, and the neck/scalp region is cleaned with an antiseptic. The doctor inserts a tiny needle into the scalp area and injects an anesthetic and/or corticosteroid. Several injections may be required.

What can I expect after the occipital nerve block?

Unless you have complications, you can return to work the next day. Expect some soreness at the injection sites, which resolves over time. You may notice immediate pain relief, due to the injected anesthetic. In 3-4 days, the steroidal agent starts to work, offering long-lasting pain relief. Most patients drive themselves home, and we advise you to use an ice pack to relieve tenderness.

How many occipital nerve blocks are needed?

You may have long-term relief of pain from only one series of injections. However, if the first injection does not relieve your pain, the pain specialist may recommend you get another one. Many patients have a series of three injection sets spaced over 1-3 months.

Does the occipital nerve block work for headaches?

In a 2015 randomized controlled study, the occipital nerve block was used to treat chronic migraine headaches. In the study, researchers divided the patients up in groups. In group A, the patients received a placebo block once a week for 4 weeks. In group B, the block was done using bupivacaine. The investigators concluded that the occipital nerve block with bupivacaine (an anesthetic) was superior to placebo. In another study the block was found to have an efficacy rate of 90% when treating chronic migraine and brush allodynia.


Afridi SK, Shields KG, Bhola R, Goadsby PJ. Greater occipital nerve injection in primary headache syndromes–prolonged effects from a single injection. Pain. 2006; 122(1-2):126-129.

Dach F, Éckeli ÁL, Ferreira Kdos S, Speciali JG. Nerve block for the treatment of headaches and cranial neuralgias – a practical approach. Headache. 2015; 55 (Suppl 1):59-71.

Dilli E, Halker R, Vargas B, et al. Occipital nerve block for the short-term preventive treatment of migraine: A randomized, double-blinded, placebo-controlled study. Cephalalgia. 2015; 35(11):959-968.