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. 

Home » Treatments » Occipital Nerve Block Treatment
Find a Location

Enter your address, zip-code, or city below:

Pain Quiz

Find the right treatment for you.

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.

More Resources:

Blue graphic showing the treatment area of an occipital nerve block

Request Appointment

View Webinar Events


Patient Testimonials


Full 1

I LOVE LOVE LOVE this office. I was helping my mom find a place for her arthritis pain, and I explained to them how bad it was. They were able to schedule me the same week! That's almost impossible at any doctor's office...and then add COVID..... I was thrilled. I took my mom, and everyone was absolutely so sweet and kind

- Donyasha B.

Dr. Rao. I can't find the words to tell you how much he has meant to me. I followed him from an old practice to his very new high tech office. They offer so many different areas of assistance to those with issues from nutrition to spinal surgery...and much more. His office is professional.

- Mom To2

Full 1

Dr. Roa is such an amazing doctor! During my first visit he never tried to rush through my appt., he genuinely listened to all my concerns and then took his time to explain to me in detail all his recommendations and how they would help me.

- Nikki Walker

In the 3 years as a patient of Dr. Rao, it is my opinion that he is a phenomenal and extraordinary doctor. He keeps up to date with the latest treatment options, will sacrifice time no matter how many are in the waiting room to listen and explain. Dr. Rao has treated multiple patients with rare illnesses, and shows more empathy than any Dr. I’ve met.

- Mom To2

Full 1

I have now been with Dr. Rao for 13 years. He is the most caring Doctor I have ever been to! Dr. Rao makes you feel very comfortable at all times. I would not want to go to any other Doctor... I go to the Hagerstown location, everyone is very nice

- Theresa R.

The entire staff from the folks at the front desk to the Nurse, to the Physicians Assistant to the scribe that records the visit for the doctor - (great idea so the Doctor can focus on the patient!!!)

- NVA F.

Full 1

Completely the best care you could want the staff is so pleasant and caring and the doctors have true heart for healing, love being a patient here would give 10 stars if I could & absolutely the most caring during my procedure with Dr B

- Cathern C.

Always friendly, courteous, and efficient service. From the ladies, who work the front desk, to the nurses and the doctors. I've always had a good experience with the Harrisonburg office in Virginia.

Krystal Shaffer

Full 1

They scheduled my appointment very quickly so that I can get to help that I needed immediately instead of like most places having to wait two to three weeks to get in I called and was able to be seen the next day

- John H.

After transitioning from a pain and spine doctor in Columbia, MD.. The intake staff member at Pain and Spine Specialist made the scheduling a breeze. They were able to get me in within a week.

Rashawn JJ

previous arrow
next arrow

Digital Guide

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!

Pain and Spine Specialists Digital Guide pages

We Accept All Insurances

Individualized Patient Care

Board Certified Doctors

Patients Seen Within Two Weeks

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.  


How To Get Started

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.  

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. You can call (301) 703-8767 (Maryland), (724) 603-3560 (Pennsylvania), or (540) 433-1905 (Virginia) and schedule an appointment today. 

Occipital Nerve Block Injection Specialists

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. 

Our Providers

At Pain and Spine Specialists, our team of physicians and nurse practitioners are committed to giving you the most effective treatment when treating your pain. We believe that all patients should have access to quality care, and that is why you can find us conveniently located throughout Maryland, Pennsylvania, and Virginia.

Helpful Resources

Our Providers

At Pain and Spine Specialists, our team of physicians and nurse practitioners are committed to giving you the most effective treatment when treating your pain. We believe that all patients should have access to quality care, and that is why you can find us conveniently located throughout Maryland, Pennsylvania, and Virginia.

Download our

Digital Guide

Everything you need to know about our services, locations, treatments, frequently asked questions and much more! 

Contact Us

Please select an option below

At Pain and Spine Specialists we are dedicated to providing the highest quality of care to our patients.We provide tailored services with each individuals comfort in mind. Select an option below:

Please note: We accept Workers Compensation Insurance and Personal Injury Patients 

Please note: We accept Workers Compensation Insurance and Personal Injury Patients 


Patient Forms