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The occipital nerves exit from the spine in the upper part of the next and supply the muscles of the neck, back of the head (occiput), and also send branches to the membranes lining the brain. Age-related changes in the upper neck can lead to irritation of these nerves, which in turn can lead to intense headaches and neck pain. The headaches can be associated with tingling, numbness, or a feeling of insects crawling over the skin (formication). Greater occipital nerve blocks are commonly performed procedure to treat these headaches. They are is a simple low risk injections that can be performed in the consultation room. 


Because the nerves also supply the membranes of the brain, this treatment can also be effective for migraine.

Occipital nerves


Greater occipital nerve blocks are intended to give meaningful pain relief from cervicogenic (neck-related) headaches, neck pain, or migraines. Although the duration of this pain relief is difficult to predict, many patients find that the injections last for some months. If they are effective then they can be repeated.  There is always the chance that although the injections are performed correctly, they are ineffective in treating symptoms.


We perform many hundreds of injections each year with no complications. However, as with any medical treatment, there are some risks that we will discuss with you. Specifically, we will mention:

  • a risk that the treatment will not work for you

  • bruising

  • infection

  • if you are a female patient, you may experience abnormal vaginal bleeding following a steroid injection anywhere in the body.

  • very rarely, steroids used by any route (eg by mouth, inhaled, injected) can cause visual problems. If you have any visual disturbance following a steroid injection, you will need to be seen by an eye specialist to rule out any serious cause.


This is a treatment that can be performed in the consultation room. Sometimes it is possible to perform it on the day of your first consultation. Sometimes patients wish to have a little bit of time to think about the options before committing to an injection.  Although we can perform this injection when you are taking blood thinning medications, it is always important for us to know that you are on these treatments, so please inform your Bath Pain management Consultant when you are discussing your symptoms, or let our administrative staff know prior to your appointment.


Prior to the injection you will have an opportunity to discuss your symptoms fully with your Bath Pain Management consultant. You will have a range of options offered to you, and the risks and benefits of any injection will be explained clearly to you. If you wish to go ahead with this injection treatment, it can be carried out in the consultation room.


There will usually be a nurse present to support you during the injection.  The injection is usually performed with you sitting on the edge of a bed. It is carried out under local anaesthetic, and although it can be uncomfortable when the injection is performed, any discomfort is usually very brief.  The injection is often combined with trigger point injections to the neck muscles for the trapezius muscles across your shoulders.


After the treatment you will be asked to stay in the hospital a short period of time. This is to ensure that if you have a reaction to the medication, you are a place where we can look after you.  After this you will be able to go home.  As with many steroid-based injections, it may take up to ten days for the full effects to become evident. 


If you are a private patient you will receive a telephone call to check on your progress within three to four weeks. Please note that we are unable to leave answerphone messages for confidentiality reasons, unless your answerphone clearly states that you are the owner and we have your permission. You may be invited back for, or request a follow-up consultation to go through other non-injection treatment options. 

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