Occipital nerve block

Occipital nerve block injections can reduce how often young people get severe headaches. This information sheet from Great Ormond Street Hospital (GOSH) explains how they work and what to expect when you come for treatment.The occipital nerves run from the back of your neck, up and over the top of your head. When the occipital nerves become inflamed, you get a headache. The injections numb the nerves so make the headaches less painful. You may also have fewer headaches than usual after the injections.

What happens when I have the injections?

You will only need to stay on the ward for a short time to meet the team and to have the injections – you will not need to stay overnight on the ward. When you arrive, the doctor and nurse will give you a checkup to make sure you are well enough for the injections. They will explain the injection procedure again and ask you to sign a consent form to give your permission.

The doctor and nurse will ask you to sit on the bed and keep as still as possible. They will clean the back of your head with antiseptic, which will feel a bit cold but will not hurt. They will then stand behind you to give you the injections around the nerve. These are above your hairline at the back so will not leave an obvious mark.

After the injections, they will ask you to lie down for a few minutes and stay on the ward for an hour or so. If you are feeling alright, you will be able to go home. When you get home, try to take it easy for the rest of the day and get a good night’s sleep.

Will they hurt?

The injections can be a bit uncomfortable as they irritate and numb the nerve. Some people feel dizzy, faint or have a stiff neck after the injections. You will feel better if you keep moving. The back of your head may ache a little but regular pain medicines will help for the next day or two. Often people can have a headache brought on by the injections – this may last for some time (perhaps up to 10 days) but gradually improves.

Very rarely, people develop a tiny bald patch around the injection site. There is also a small chance you could have an allergic reaction to the injections – this could make the skin red and itchy. Ask someone to check the injection sites for the next few days and let us know if it is red or feels hotter than the surrounding skin – this could be a sign of infection.

How will I know if they have worked?

As the pain gets better, try to do more activity – perhaps go for a walk or a swim. Gradually increase what you for the next few weeks but try not to ‘boom and bust’ where you overdo it on a good day and then cannot do much the following day.

Please make sure that you complete the questionnaires before and after the injections, so that we can assess how helpful they have been for you. This will help us to decide if future injections will be useful for treating your headache. We hope that you will
have milder headaches or fewer headaches following the injections.

Compiled by:
the Neurology department in collaboration with the Child and Family Information Group
Last review date:
August 2017