Greater / Lesser Occipital Nerve Block


What is an Occipital Nerve Block?

  • The occipital nerves run from the top of the spinal column up to the back of the scalp.
  • An occipital nerve block involves an injection of local anaesthetic and steroid onto the area of the occipital nerves.
  • This is performed in order to treat headaches arising from the following causes:
    • Occipital neuralgia (pain is typically located in the back of the head / neck);
    • Whiplash injuries;
    • Tension headaches.


Prior to the Procedure

  • All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time your admission date is arranged.
  • You will need to organise someone to drive you home after the procedure as you will not be able to drive for a minimum of 4 hours after your procedure. 


What Will Happen?

  1. You will be admitted to the day surgery by a nurse.
  2. The anaesthestist will speak with you and insert a cannula (plastic needle) into your hand or arm if you are having sedation.
  3. In the procedure room, you will be positioned onto the X-ray table.
  4. The tender spots will be felt at the back of your skull. The area will then be cleaned with a chlorhexidine solution or alcohol wipe.
  5. Corticosteroid and local anaesthetic will then be injected into the target site.
  6. Some pressure will be applied to the area for a couple of minutes at the end of the injection.
  7. If both sides of the back of your skull are to be injected this may need to be performed approximately 30 minutes apart or on two separate occasions. 


Post Procedure

  • You will not be able to drive for 4 hours after your procedure. 
  • You will be allowed home 1 hour after sedation with your carer/driver.
  • If you have local anaesthetic only, you may be required to stay 20 minutes.
  • If a strong local anaesthetic has been used, it will wear off in 12 - 18 hours.
  • The steroid will take approximately 48 hours to start working.
    • During this time there may be a window of increased discomfort or pain.
  • We suggest you take it easy for 24 hours prior to returning to your pre-injection activities.
  • A follow up appointment or repeat injection may be arranged prior to leaving the clinic. 
  • The effect of the nerve block may be felt for 1 – 6 months, depending on the amount of irritation or inflammation present. 

If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.


* Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons