Occipital Nerve Block for occipital neuralgia:
An occipital nerve block is done when there is inflammation of the occipital nerves (located in the back of the head) that is causing headaches. Local anesthetics and a steroid are injected into the occipital region in order to reduce inflammation of the nerves and provide pain relief. This procedure does come with possible risks. Complications that can occur include but are not limited to bruising, infection, and adverse reaction to the medication. Administration of a steroid medication may cause side effects. Potential side effects include but not limited to elevated glucose levels, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, or osteoporosis. Alternatives to the procedure include oral medications, physical therapy, or acupuncture. Benefits include decrease or elimination of your pain. Risks include infection, bleeding, bruising, allergic reaction, increased pain, nerve damage involving temporary or permanent pain/numbness or weakness. Any benefits resulting from the procedure tend to wear off after about 6-8 weeks with a repeat injections required if benefit is to be maintained. Injections are done every 8 weeks with maximal effect peak achieved after approximately 16 weeks.
Occipital nerves travel from your neck to the back of the head and scalp. An injection of local anesthetic and sometimes steroid medication can temporarily reduce headaches caused by muscle spasm and tension. All procedures in medicine carry a risk of complications. Precautions are always taken to minimize the risk as far as possible, but the following risks may occur:
- Failure of the procedure to reduce pain
- Worsening of pain (temporarily or permanently)
- Bleeding/bruising to the injected area
- Allergic reactions
- Numbness (temporary or permanently)
- Infection in the injected area
- Nerve damage -a very small risk
There are minimal side effects associated with either single or occasional use of steroids. These include hot flushes, feeling sick, mild abdominal pain, fluid retention, raised blood sugars in diabetics and occasional menstrual irregularities and should settle in a few days. If you take water tablets (diuretics) on a regular basis please take an extra tablet the next day. If you are diabetic you should closely monitor your blood sugar for two weeks after your procedure. Repeated and frequent use of steroids has the potential to lead to more serious effects but the doses of steroids given in the injections are minimal compared with the doses of steroids taken by mouth on a regular basis.
- Injection Appointment:
This is strictly a procedure visit, you will need to schedule a separate appointment for anything other than injections. Once you check in you will be given a consent form to review and sign. The procedure generally takes between 5-10 minutes. The injections will be performed by the Physician Assistant. You may wear your normal clothing. Please have your hair pulled up. It is ok to resume normal activity (work, driving, etc.) after your injections as tolerated.
Follow-Up Appointments and Treatments:
You will schedule a follow up appointment 2-3 weeks after injections to discuss your response to the medication and other medication management if needed. You will be scheduled for injections every 8 weeks. If you are unable to maintain an 8-week injection regiment the occipital nerve blocks will not be beneficial and as such we recommend you do not enroll in the program. Please do not leave the office until you have confirmed a date that works for you and also fits within your treatment regimen.
How You Can Help:
You play an important role in your treatment. Below is a list of things you.
can do to be an active participant in your treatment plan:
- Notify us immediately of any changes in your insurance
- Keep scheduled appointments and notify us as soon as possible if you need to change your appointment