Published September 24, 2024, Authored by Dr. Adam Lowenstein

At our clinic, we often encounter questions regarding the efficacy and occipital nerve block side effects injections, particularly in the context of migraine treatment. Today, I want to share some insights that might clarify why occipital nerve block for migraine, while generally beneficial, can sometimes exacerbate pain before providing relief.

Understanding Nerve Blocks

A nerve block involves the occipital nerve block injection of medication, usually a local anesthetic or a steroid, directly around a nerve or into the area surrounding it to alleviate pain. When I administer nerve blocks, I primarily use local anesthesia which works by temporarily shutting down nerve activity to provide immediate pain relief.

The Role of Steroids in Nerve Blocks

However, when steroids are used, the approach and outcomes can differ significantly. Steroids are not immediate in their action; they work gradually to reduce inflammation and alleviate pain. Initially, the injected steroid can act as an irritant to the surrounding tissues, which may increase discomfort or pain temporarily. This initial irritation can make the nerve ‘angry,’ leading to exacerbated headache symptoms in the short term.

Why Your Reaction to Nerve Blocks Matters?

The response to a nerve block can be very telling. If a nerve block temporarily alleviates your pain, it indicates that you might be a good candidate for occipital nerve decompression surgery near me or migraine surgery. Conversely, if a nerve block worsens your pain, it still suggests that the targeted nerve is a significant player in your headache symptoms. In both scenarios, the nerve block acts as a diagnostic tool, helping to confirm that the peripheral nerves (like the occipital nerves or the supraorbital nerves) are involved.

  • The Importance of Expert Administration: It’s crucial that nerve blocks are administered by someone with deep knowledge of nerve anatomy. As a migraine surgeon, I perform these injections with a precise understanding of where these nerves are located and how deep they need to be reached. Unfortunately, not all practitioners, including some neurologists and pain doctors, possess this specific expertise, which can lead to ineffective blocks.
  • Exploring Further Options: If you do not experience any change after a nerve block, or if you’ve had unsuccessful nerve blocks in the past, I recommend seeking a second opinion from a specialist who is experienced in performing these procedures for migraine relief. I have personally seen many patients who did not respond to initial nerve blocks performed elsewhere but found relief after a properly targeted block in our clinic.

Occipital Nerve Block for Migraine FAQ

What is a Nerve Block?

A nerve block is a procedure that involves the injection of a numbing substance, often combined with a steroid, around nerves that are causing pain. This technique is used to diagnose and manage various types of pain, including occipital neuralgia, which affects the nerves running from the top of the spinal cord up through the scalp, causing intense headaches.

How Long Does a Nerve Block Last After Surgery?

The duration of relief from a nerve block can vary depending on several factors, including the type of medication used. Typically, the effects can last from several days to several weeks, providing significant relief.

What is a Nerve Block Injection?

A nerve block injection involves injecting medication directly into the area around the nerve to reduce inflammation and “block” pain signals sent to the brain. It’s a quick, outpatient procedure that can diagnose the cause of pain as well as provide temporary relief.

How Long Do Nerve Block Injections Last?

The pain relief from a nerve block injection can last from a few hours to several weeks. For many patients, these injections are part of a broader pain management strategy that may include physical therapy, medication, or occipital nerve decompression surgery.

What Steroid is Used for Occipital Nerve Block?

Typically, the steroids used in occipital nerve blocks include corticosteroids such as triamcinolone, methylprednisolone, or dexamethasone. These steroids help reduce nerve inflammation and lessen pain.

What is the Success Rate of Occipital Nerve Block?

The success rate of occipital nerve blocks varies, but many patients experience substantial relief from their symptoms. These outcomes depend on the exact nature of the neuralgia and the individual’s response to the steroid.

How to Sleep After an Occipital Nerve Block?

After receiving an occipital nerve block, it’s best to sleep with your head elevated to reduce discomfort. Using extra pillows to keep your head raised can help manage swelling and maximize comfort during sleep.

Can I Drive Home After an Occipital Nerve Block?

It is generally recommended to avoid driving immediately after an occipital nerve block due to potential numbness or dizziness. Arranging for someone to drive you home is a safer option following the procedure.

Understanding that the pain from nerve blocks is due to the irritation of the nerve itself underscores the origin of the problem—peripheral nerve irritation. Our approach aims to address this root cause through minimally invasive outpatient procedures. With a high success rate, many of our patients experience significant, if not complete, relief from their symptoms.  Our nerve blocks are primarily performed to see if a patient is a candidate for occipital nerve decompression surgery.  

If you’re experiencing chronic headaches and think occipital nerve block for migraine or nerve decompression surgery might help, don’t hesitate to reach out. Visit our website at headachesurgery.com for more information or to schedule a consultation. We are here to help clarify your situation and guide you towards a pain-free life.

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