What is a Nerve Root Block?

The occipital nerves travel from the cervical spine in the neck to the back of the head and scalp. These nerves can be irritated by muscle spasm, arthritic changes or by neck injuries. You may be experiencing headaches which typically start in the back of the neck and spread towards the forehead.​

Occipital nerve blocks with steroids can often help with the treatment of these kinds of headaches. Our team of pain providers at Arizona Pain Treatment Centers utilize the benefit of occipital nerve blocks as well as physical rehab to address the headache and irritated occipital nerves.​

Essentially an Occipital Nerve block is numbing of the greater and lesser occipital nerves. The block is an injection composed of an anesthetic and a corticosteroid next to the greater and lesser occipital nerves, which are located just beneath the scalp, superficial to the skull, in the back of the head.

Occipital Neuralgia will typically follow a trauma to the nerves over the occiput (back of the head) and is characterized by an acute onset of pain in the distribution of the occipital nerves. A Cervicogenic headache is more chronic, with an insidious onset, characterized by pain in the same distribution. Most patients with cervicogenic headaches have associated degenerative or inflammatory changes in the joints in the neck and therefore may need an additional block in the cervical facet joint to completely alleviate their symptoms.

Anatomy

The occipital nerves arise deep in the neck near the spine but become superficial (close to the skin) behind the ear. These nerves supply sensation to the back and side of the scalp and are commonly involved in patients suffering from cervicogenic headaches and Occipital Neuralgia.

​Procedure

The procedure involves inserting a small needle through the skin beneath the scalp in order to get the anesthetic and corticosteroids around the area of the nerve.

​The injection blocks both the greater and lesser occipital nerves. There are two major benefits to using this block. Not only is it useful in treating Occipital Neuralgia, relieving or reducing pain in the back of the head in the scalp, but if symptoms improve after the injection then the block is also useful in diagnosing Occipital Neuralgia.

Typically, if you respond well to the injection and have pain relief then it is recommended that you return and receive repeat injections. Usually, a series of block injections is needed to treat the problem adequately; however the response to the block varies from patient to patient. Also, if you respond well to the Occipital Nerve block then you will most likely benefit even more with the addition of Occipital Nerve Stimulation.