Occipital Nerve Block

An occipital nerve block is an injection of local anesthetic and steroid around the greater and/or lesser occipital nerves — the nerves that supply sensation to the back and top of the scalp. These injections provide relief for occipital neuralgia, cervicogenic headache, and certain migraine patterns.

Conditions Treated

Occipital Neuralgia: Shooting, stabbing, or electric pain radiating from the base of the skull to the top of the head — sometimes accompanied by scalp tenderness. Occipital nerve blocks are first-line treatment.

Cervicogenic Headache: Headaches originating from the upper cervical spine and transmitted to the head via the occipital nerves. Often mistaken for migraines.

Chronic Migraine: Occipital nerve blocks are used as adjunctive treatment to reduce migraine frequency, particularly when the occipital region is involved.

Cluster Headache: Some patients with cluster headache respond to occipital nerve blocks as part of a multimodal treatment plan.

The Procedure

Dr. Rubin palpates or uses ultrasound to identify the occipital nerves at the base of the skull, then injects a small amount of local anesthetic and steroid. The procedure takes only 5–10 minutes in the office. Most patients notice the injection on both sides (bilateral blocks are typically performed).

Results

Many patients experience immediate relief from the local anesthetic component, with ongoing benefit from the steroid lasting weeks to months. Occipital nerve blocks can be repeated at appropriate intervals.

For patients with occipital neuralgia who do not achieve durable relief, pulsed radiofrequency treatment of the occipital nerves is an option that Dr. Rubin can discuss.

Contact Us

If you experience pain, tingling, or tenderness at the back of your head that may indicate occipital neuralgia or cervicogenic headache, call 516-492-3100 for an evaluation.