The occipital nerves run from the base of the skull up over the back of the head. When pain starts there and travels upward, those nerves are often where it is coming from. A block places an injection near them.
It acts quickly. Relief can begin within minutes, and it can last weeks. How long it lasts is useful in itself: it is what the decision to repeat is based on.
What it treats
Occipital neuralgia. Sharp, shooting or burning pain that starts at the base of the skull and travels up over the back of the head, often on one side. The scalp can be tender to touch between attacks.
Some migraines and cluster headaches. Not all of them. Where the pain pattern points to the occipital nerve, a block can help, and the response is part of how that is established.
Which category you are in is worked out at the consultation from your headache history, where the pain sits, and an examination of the area. It is not decided from a description over the phone.
What a session is like
You sit upright and lean forward slightly. The area at the base of the skull is cleaned, the landmarks are found by feel, and the injection is placed. It takes a minute or two.
- Session length
- About 15 minutes, and about 30 for a first visit with the assessment.
- Sensation
- Pressure and a brief sting. The area is often already tender.
- Onset
- Relief can begin within minutes.
- How long it lasts
- Days to several weeks. It varies a great deal between people.
- Cadence
- Repeated based on how long relief lasts, rather than on a fixed interval.
- Downtime
- None. Numbness over the area for a few hours is expected. Soreness or a small bruise for a day or two.
Before, during and after
This is the protocol we follow. Open any of these to read it before booking, or again the week of your appointment.
Common questions
How quickly does it work?
Relief can begin within minutes. The area at the back of the head usually goes numb for a few hours, and the headache can briefly return as that numbness wears off. Where a longer-acting component is included, its effect builds over a few days, so the first day is not the whole picture.
How long does it last?
It varies, from days to several weeks. The duration is not incidental information. It is used to decide when, or whether, to repeat the block, so noting the date it wore off is one of the more useful things you can do afterwards.
How often can it be repeated?
Based on how long relief lasted rather than on a fixed calendar. If a block holds for six weeks the interval follows that. If it holds for a few days, that is worth knowing too, and it usually changes the plan rather than simply repeating the same thing sooner.
Does it hurt?
There is pressure and a brief sting, and the area is often already tender, which people notice more than the needle. It takes a minute or two. Soreness or a small bruise for a day or two afterwards is common, and a cold pack for ten minutes at a time helps.
What is in the injection?
What goes into the block is decided at the visit, from your history and what the block is for. It is set out in the care instructions and gone through with you before anything is done, including the points that matter if you have diabetes.
Can I drive home?
Most people drive themselves home. For a first block it is worth having someone you can call, because a small number of people feel lightheaded afterwards. Take it easy for the rest of the day. Showering is fine.
This page is for general education and is not medical advice. It does not establish a physician-patient relationship, and it cannot account for your individual history, medications or skin. Suitability for treatment is decided at consultation following examination.