Occipital Nerve Block

An occipital nerve block is a minimally invasive injection procedure that administers pain-relieving medicine to occipital nerves in order to reduce pain from chronic migraines and headaches. 

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Occipital Nerve Block Injections

Inflammation of occipital nerves can cause occipital neuralgia, migraines and cluster headaches. A occipital nerve block or ONB injection uses a steroid anti-inflammatory medication and a long-lasting anesthetic to target inflamed nerves in the neck. Once administered, the medication prevents these nerves from sending pain signals to brain. 

Our pain management doctors will administer the injection using fluoroscopic guidance to the occipital nerves located in the back of the head near the neck. Some patients experience immediate relief, but the full-effects can take up to 3-5 days.

To learn more about Occipital Nerve Blocks use the "more resources" buttons below. If you have more questions or if you are ready to schedule an appointment, use are contact form here.

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A comprehensive guide with everything you need to know about our providers, locations, conditions we treat, treatments we offer, and many other frequently asked questions!

A comprehensive guide with everything you need to know about our providers, locations, conditions we treat, treatments we offer, and many other frequently asked questions!

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Occipital Nerve Block Injections

Unfortunately, many people suffer from chronic headaches and migraines. They report the pain typically starts from the base of their neck moving to the base of their skull. They experience the pain radiating and settling in their temple, top of their head, and their eyes. Sometimes it’s a combination of these locations on the head where pain is felt.  

The base of the skull is where the occipital nerves reside. The nerves on each side of the head emerge between the bones of the spine and upper neck. The occipital nerves make their way at the back your head and into your scalp.  

Irritation of these nerves causes a specific type of pain, classified as “occipital neuralgia.” Responsible for the majority of the physical feelings in the back and top of your head, the occipital nerves emerge between the bones of the spine in the upper neck. Inflammation of these nerves can cause occipital neuralgia (migraines and headaches).  

The irritated occipital nerves can be felt near your eyes and the same side of your head. This type of pain is also known as a type of referred pain.  

Occipital neuralgia can be inconvenient and sometimes debilitating. You may feel unable to move or participate in your daily activities because the pain is incapacitating.  

Occipital nerves blocks can be used to treat and manage chronic headaches and migraines. Some conditions that may benefit from an occipital nerve block procedure are: 

  • Occipital Neuralgia: A headache disorder that feels like shooting pain in the back of your head and the sides of your neck. 
  • Cluster Headaches: A short, but painful series of headaches that are reoccurring.  
  • Migraines: A neurological condition that causes intense headaches that commonly produce nausea, dizziness, and mood changes.   

If you are experiencing any of these conditions, an occipital nerve block can help treat and manage your pain. Sometimes blocking the occipital nerve will reduce the headache and its associated symptoms.

Occipital nerve block injection

What Is An Occipital Nerve Block?  

When discussing your head pain symptoms with your pain management provider, they may recommend a single (or series) of occipital nerve block treatments.  

An occipital nerve block is administered by a physician who is knowledgable in pain management therapy. These physicians include physiatrists, anesthesiologists, neurologists, radiologists, and surgeons.  

It is important to discuss other aspects of your health and medications with your pain management specialist to ensure the most effective results. Some medications, supplements, or vitamins may need to be stopped prior to your procedure due to their potential interactions with the nerve block. 

The ONB injection will contain a steroid anti-inflammatory medication and a long-lasting anesthetic.


What To Expect During An Occipital Nerve Block 

Your pain and back specialist will have you lay on your stomach while they numb the surrounding skin with a local anesthetic. This will help the patient avoid pain during the nerve block procedure. It also can help confirm the source of the pain. 

With fluoroscopic guidance, a needle is guided to the occipital nerves where medication is administered. These nerves are located above the neck area of the back of your head. The entire procedure takes a few minutes where the patient is awake the entire time. You are encouraged to take it easy with rest and relaxation the day of your injection. But patients are able to resume their normal daily activities the next day.  

The administered medication will begin working within 3-5 days. Some patients may even experience immediate pain relief from the anesthetic that turns into longer-lasting pain relief from symptoms.  

The medication can be effective for weeks to months. If you have a positive result from your ONB injection, your doctor may recommend to utilize these injections again if the symptoms return. They may even recommend a series of the injection depending on the severity of your occipital nerve pain.  

Some tenderness at the injection site may be expected. This procedure blocks the pain from the nerves through its “numbing” effect. The steroid injection reduces swelling and inflammation, relieving pressure from the pain originating from the occipital nerves. Treating this irritation and inflammation can also provide relief from the associated pain symptoms.  

While your pain physician may recommend more than one occipital nerve block injection, it is rare to receive more than three ONBs in a six-month period. The more steroid that is injected to a patient, the greater the chance of potential side effects.  

Occipital nerve blocks are a minimally invasive procedure that are generally considered safe. Like any other injection procedure, there are some medical side effects to be aware of. After an ONB, some common side effects are:

  • No improvement in symptoms
  • Magnified head pain
  • Stronger headaches
  • Dizziness
  • Light-headedness
  • Infection at injection site
  • Numbness
  • Potential nerve damage (minimal risk)

If the first occipital nerve block does not provide a successful result in relieving patient pain within the first week or two, it may be necessary to have a second injection. 

If you and your doctor determine that more frequent injections are needed, other treatment options may be considered. These more minimally invasive treatments may include:

  • Cutting of specific nerves
  • Small doses of radiofrequency administered to the nerve cells
  • Inserting an occipital nerve stimulator (which works like a pacemaker in the heart)

It is also important to evaluate if there are a lack of positive results from an occipital nerve block injection. If a patient is unable to find relief from their symptoms, it may be a sign that the occipital nerves are not the source of the pain. If this is the case, our comprehensive pain management specialists will work with you to determine the source of your pain and determine a new treatment course.  


Those who are allergic to steroids or the other medications that are included in the injection should not have an ONB. People who are also on blood thinner or may have an active infection are not appropriate candidates for this procedure.  


Treatment At PASS

In addition to occipital nerve pain and inflammation, Pain and Spine Specialists is able to successfully treat other sources of nerve pain with progressive injection procedures such as ESIs and RFAs. We offer multiple modalities that can be incorporated collaboratively in your pain treatment such as medication management, injections, and alternative therapies.  

About Us

We are a comprehensive pain management practice with board certified Occipital Nerve Block doctors in Maryland, Pennsylvania, and Virginia.

Pain Regions

Occipital Nerve Block is often used to treat pain in the following regions:

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How To Get Started

If you would like more information about how we can treat your occipital neuralgia, other head pain symptoms, please call us! Our dedicated team will work with you to improve the quality of your life. 

Frequently Asked Questions

Occipital Nerve Block FAQ's

What types of doctors offer Occipital Nerve Block?

Pain management specialists, anesthesiologists, neurologists, and some types of surgeons (such as neurosurgeons or orthopedic surgeons) may offer Occipital Nerve Block treatments.

Is Occipital Nerve Block covered by insurance?

Generally, yes. Most insurance companies cover Occipital Nerve Block, but it can vary based on your specific plan and provider. It's recommended to contact your insurance company for confirmation.

What are the alternatives to Occipital Nerve Block treatment?

Alternatives could include medication management, physical therapy, acupuncture, lifestyle changes like stress management and avoidance of trigger factors, other types of nerve blocks, or surgical interventions.

Is Occipital Nerve Block considered minimally invasive?

Yes, Occipital Nerve Block is considered a minimally invasive procedure as it involves only a small injection in the occipital region of the head.

How do I find a Occipital Nerve Block treatment center near me?

You can use online search engines or medical directories to find treatment centers near you that offer Occipital Nerve Block. You could also ask for recommendations from your primary care physician or a local hospital.

How do I find a Occipital Nerve Block specialist near me?

Similar to finding a treatment center, you can use online resources or ask for recommendations from healthcare professionals to find a specialist who offers this treatment.

Is Occipital Nerve Block considered a minimally invasive treatment?

Yes, it is considered a minimally invasive procedure.

How much does Occipital Nerve Block cost?

The cost can vary greatly depending on your location, the specific healthcare provider, and whether or not you have insurance. It's best to contact potential providers directly for an accurate quote.

What treatments are often tried before considering Occipital Nerve Block?

Typically, less invasive treatments such as medications, physical therapy, and lifestyle modifications are tried first.

What are the reviews for Occipital Nerve Block?

Reviews can vary widely, as effectiveness can depend on the individual's specific condition and response to treatment. It's best to consult with a healthcare professional and read reviews from credible medical websites.

Do Medicare and Medicaid cover Occipital Nerve Block?

Coverage for this procedure under Medicare and Medicaid can vary, so it's best to check with your specific plan.

Billing / Insurance Questions

We Accept All Insurances!

That includes Medicare and state Medicaid.

How Soon Can I Be Seen?

Usually within one week of the initial call.

Appointments can be schedule by phone or through our contact form here.

What To Expect During Appointments

At Pain and Spine Specialists we provide comprehensive pain care while offering the most up-to-date minimally invasive techniques. Our ethos is to treat each patient (and potential patient) as if they were a family member.

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At Pain and Spine Specialists we want to provide the most efficient and pleasurable experience possible. As in all medical facilities, we have certain policies in place to ensure that you receive the time you require to address your needs as well as enhance your experience while in our care.

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We encourage patient feedback to better improve your experience. We strive to create a friendly and warm environment where patients feel their voices are heard and validated.

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Occipital Nerve Blcok Doctors in Maryland, Pennsylvania and Virginia

At Pain and Spine Specialists, our team of occipital nerve block specialists are committed to giving you the most effective treatment when treating your pain. We believe that all patients should have access to exceptional care.