An Overview of Occipital Nerve Block Injections
Occipital nerve blocks refers to injections performed at the top of the neck where it meets up with the skull. These are outpatient injections that provide excellent pain relief for numerous types of headaches and occipital neuralgia. Pain relief may last for months and decrease both the level of pain and the frequency of headaches!
What are the Occipital Nerves?
The occipital nerves originate on both sides at the back of the neck, close to the skull. The greater occipital and the lesser occipital nerves are located on both the right and left sides of the neck.
These nerves provide sensation to the back of the head, and have no motor function whatsoever. When inflamed, these nerves can lead to significant headaches that usually show up on one side of the back of the head.
The great news is these nerves are not vital for any head movement or life functions, so if they end up needing to undergo a radiofrequency ablation it is not a problem in that regard.
What Conditions Benefit from Occipital Nerve Blocks?
Occipital nerve blocks may help numerous types of headaches. First and foremost, they are designed to reduce the pain from occipital neuralgia, which typically causes the most pain on one side of the back of the head.
They have been shown to work well for migraines, cluster headaches and cervicogenic headaches. Not only do they reduce the pain of these headaches, they can also reduce the frequency of occurrence.
How are Occipital Nerve Blocks Performed?
These injections may be done in an office setting or procedure room. The Los Angeles pain management doctor will inject at the area that is most tender, and typically the skin is numbed up along with the soft tissues down to where the occipital nerves are.
The pain management doctor injects numbing medicine and potentially some cortisone (steroid) to provide pain relief. The doctor may also use phenol to provide longer lasting relief. This is a form of alcohol.
What are the Outcomes from Occipital Blocks?
Occipital blocks have been shown to provide exceptional headache relief. For cervicogenic headaches, over 95% of patients receive 6 months of pain relief with these injections (Pain Pract 2006). When it comes to cluster headaches, eighty five percent can expect to become free of headaches for one to four months. (Pain. 2005)
The numbers for occipital neuralgia and migraines are just as encouraging. The blocks have shown an 85% rate of good to excellent results for pain relief from headaches for up to six months. (Clin Neurol Neurosurg 1992).
The additional good news is when the pain relief wears off, a repeat procedure should provide repeat pain relief.
Occipital radiofrequency ablation is one of the newest methods of treating neuralgia and headaches. Los Angeles pain doctors will use pulsed radiofrequency ablation, and results in initial studies have been very encouraging with average reductions on VAS pain scale going down by over 7 points (J Korean Neurosurg Soc. 2012). Another study showed over 50% of patients received over 50% pain relief for an average of 3 months (Pain Med. 2012).
Lastly, spinal cord stimulation for the occipital nerve has shown satisfactory results in small studies for migraines and cluster headaches. As a last resort, a spinal cord stimulator may make life tolerable for patients.
What are the Risks of Occipital Blocks?
These procedures have a very low risk profile. There is a very small risk of infection, nerve injury and bleeding. If the needle goes too deep it could start a spinal fluid leak, but the occipital nerves are located behind the spinal canal completely so that would be unusual.
If the patient is on blood thinners, they should be stopped 5 to 7 days prior to the procedure. Talk to your pain management doctor in Los Angeles to find out how long prior.
If you or a loved one in the greater Los Angeles area is suffering from occipital neuralgia, migraines, cluster headaches, then occipital nerve blocks may very well be able to help you for 3 to 6 months at a time.
If these injections work and then wear off, they can easily be repeated or an individual can go on to have a radiofrequency ablation procedure. This is a procedure offering longer lasting relief by deadening the occipital nerves by using thermal heat.
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