October 28

Occipital Nerve Block for Migraines

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One of the most successful treatment approaches for occipital neuralgia are occipital nerve blocks. Occipital nerve block injections (ONB) are a procedure where a pain-relieving solution of medication are injected to the area of your skull that contains the occipital nerves. Typically a pain management physician will administer the injection to help reduce and eliminate your symptoms. The injection will contain a long-acting anesthetic and a steroid solution, which will have an anti-inflammatory effect on the occipital nerves.  


How It Works

Do you ever have what feels like the same type of migraine? Like all the time? You may experience sharp, piercing pain in your upper neck and the back of your head, or you may even feel the aching, throbbing pain from the base of your head up to your scalp. Living with these chronic migraines and headaches may feel unbearable.  

If you find yourself suffering from chronic migraines, you may actually be suffering from occipital neuralgia. You may call the pain you experience a migraine, but you cannot treat them the same. Pain from occipital neuralgia is caused by compressed (or inflamed nerves) that run from your neck, up your back, and the head of your scalp. 

In the base of your skull, you have occipital nerves. These nerves are on each side of your head and come through between the bones of your spine and upper neck. The occipital nerves make their way up the back of your head and into your scalp.  

If one of these occipital nerves become pinched, injured, or if there is muscle tightness in the neck, occipital neuralgia can be the result. Sometimes, occipital neuralgia can also be the symptoms of another primary condition. An occipital neuralgia injection can be an option to consider.  

The occipital nerves are responsible for the majority of the physical feelings in the back and top of your head. Inflammation of these nerves can cause migraines and headaches, and pain can be felt near your eyes and the same side of your head. The pain usually moves upwards. This type of pain is also known as “referred pain.” 

A regular headache or a migraine typically have identifiable triggers that you can figure out and manage. You can usually handle your pain with some over the counter medication. Drink a little extra water, or if you’re really in a pinch, drink some soda or coffee (most people nowadays have experienced caffeine headaches). But when the symptoms are frequent and not a simple fix other treatment options should be explored.  


Identifying Occipital Neuralgia

Many of the symptoms you may experience with occipital neuralgia are similar to headaches but their source is different. They may feel the same, but their source is different. The important thing is to have a medical professional examine you. They’ll be able provide you a more accurate diagnosis of the pain symptoms you’re experiencing. 

Occipital neuralgia symptoms and the effects of chronic migraines include:

  • Tender scalp 
  • Sensitivity to light 
  • Pain with neck movement 
  • Pain behind the eyes 
  • Pain on both sides of your head 
  • Aching/throbbing at the base of your head 

Injury, pressure, or inflammation on your occipital nerves cause the excruciating migraine-like pain.  


Treatments For Occipital Neuralgia 

So now you may be wondering where that leaves you. You’re experiencing migraines that are “officially not migraines” but regular over the counter pain relievers just won’t cut it. Once you’re able to determine that you’re suffering from occipital neuralgia you can be treated appropriately.   Sometimes with some gentle stretching and the application of ice and heat packs, you may be able to temporarily relieve some of your symptoms. But if you’re looking for a minimally invasive procedure 

One of the most successful treatment approaches for occipital neuralgia are occipital nerve blocks. Occipital nerve block injections (ONB) are a procedure where a pain-relieving solution of medication are injected to the area of your skull that contains the occipital nerves.   Typically a pain management physician will administer the injection to help reduce and eliminate your symptoms. The injection will contain a long-acting anesthetic and a steroid solution, which will have an anti-inflammatory effect on the occipital nerves.  

Occipital nerve blocks can also be used as a diagnostic tool as well. Let us say you and your doctor are unsure if the pain symptoms you are suffering in your head are actually from occipital neuralgia (or if they’re just chronic headaches). An ONB is a safe treatment option that can demonstrate which condition you are suffering from.   

The steroid in the ONB will really start becoming effective within 3-5 days of the procedure. It can produce positive effects for several days and months. If you experience relief from your pain, then the ONB treatment can indicate that you are suffering from occipital neuralgia and inflammation on the occipital nerves. You may even require a series of occipital nerve blocks for migraines as a preventative measure against future pain symptoms. If you do not experience any relief from the pain in your head, then you may be experiencing a different form of migraines. Your doctor will be able to determine the best treatment method for you.  

Before receiving any type of injection therapy, it is important to be honest when discussing your medical history and any medications you may be taking. Some supplements or prescription medication may need to be discontinued for a period of time before and after the ONB.  

The nerve block that your doctor might do to diagnose your condition can be a short-term treatment, too. It may take two to three shots over several weeks to get control of your pain. It’s not uncommon for the problem to return at some point and to need another series of injections. 


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Occipital Nerve Block


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