An occipital nerve block is a targeted injection of local anesthetic, often with a corticosteroid, placed around the occipital nerves at the back of the head to calm the nerve-driven pain behind many chronic headaches.
OVERVIEW
What an occipital nerve block is and how it works
The greater and lesser occipital nerves run from the upper neck across the back of the scalp. When these nerves are irritated, compressed, or inflamed, they can produce sharp, shooting, or burning pain that travels from the base of the skull up over the scalp, sometimes radiating toward the back of the eye. An occipital nerve block places a small volume of local anesthetic, usually combined with a corticosteroid, just around these nerves to interrupt that pain signal and reduce inflammation.
The injection serves two purposes. The anesthetic provides rapid, short-term relief that helps confirm the occipital nerves are the source of your pain (the diagnostic role), while the steroid works over the following days to lower inflammation and, for some patients, extends relief for weeks to months (the therapeutic role). At Columbia Pain & Spine Institute in Gresham and Portland, Oregon, our fellowship-trained physicians use this block as part of a broader headache and neck-pain treatment plan rather than as a stand-alone cure.
Commonly treats
WHAT TO EXPECT
Your visit, step by step
Before the procedure
A physician reviews your headache history, neck symptoms, and any prior imaging to confirm the occipital nerves are a likely source. Tell us about blood thinners, allergies, and any active infection, since these may change timing. No general anesthesia is needed, so you can typically eat normally and drive yourself unless we advise otherwise.
During the procedure
You sit or lie face-down while the skin at the back of the head is cleaned and numbed. Using anatomic landmarks and, when appropriate, ultrasound guidance for accurate placement, the physician injects the medication around the targeted occipital nerves. The injection itself takes only a few minutes, and the full visit is usually brief.
After and recovery
Many people feel reduced pain and scalp numbness within minutes from the anesthetic. That numbness wears off over hours, and steroid relief, when it occurs, typically builds over several days. Mild soreness or a small bruise at the injection site is common and short-lived. Most patients return to normal activity the same day. We review your response at follow-up to decide whether to repeat the block or consider other options among our nerve block procedures and broader pain care.
QUESTIONS
Frequently asked questions
How long does relief from an occipital nerve block last?
The anesthetic effect lasts hours, while steroid-driven relief varies from person to person and may last from a few weeks to several months. Because responses differ, we use your results to guide whether and when to repeat the procedure.
Is the injection painful?
Most patients describe a brief pinch and pressure. The skin is numbed first, and the injection takes only a few minutes. Some scalp soreness afterward is normal and usually settles within a day or two.
Will I be able to drive home?
Because no sedation is required for a standard occipital nerve block, most patients drive themselves home and resume their day. If your specific plan includes sedation, we will let you know in advance so you can arrange a ride.
LEARN MORE
Related care at Columbia Pain & Spine Institute
Occipital nerve blocks are one of several nerve block procedures we offer across our full range of interventional pain services. For related head, face, and neck pain, your physician may also discuss a trigeminal nerve block, a sphenopalatine ganglion block, or a suprascapular nerve block for associated neck and shoulder pain.