Occipital nerve block

What is an occipital nerve block?

An occipital nerve block is an injection given near the occipital nerves, which run from the top of the neck over the back of the head. It usually contains a local anaesthetic, sometimes combined with a steroid (anti-inflammatory) medicine.

The aim is to calm pain signals carried by these nerves. It is used for several headache types, including occipital neuralgia (where the occipital nerve itself is painful), migraine, cluster headache and some headaches coming from the neck.

It is a treatment for symptoms rather than a cure. Relief varies a lot between people, from a few days to several months, and it often needs repeating. It is usually one part of a wider headache plan rather than a stand-alone fix.

The evidence is reasonable for safety but more limited for exactly how well and how long it works, partly because many studies are small. A good clinician is honest about this uncertainty.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your procedure

• Tell the clinician about allergies, especially to local anaesthetic.
• Mention blood-thinning medicines, as these may increase bruising or bleeding.
• Say if you have diabetes, as steroids can briefly raise blood sugar.
• Tell them about any infection or skin problem at the back of the head or neck.
• Mention if you are pregnant, planning pregnancy or breastfeeding.
• Keep a headache diary so the effect of the block can be judged.
• Plan to carry on as normal afterwards, though you may want someone with you the first time.

What happens

The procedure is usually done sitting up or leaning forward. The clinician feels for landmarks at the back of your head and cleans the skin. The injection itself contains a local anaesthetic, so once it is in, the area becomes numb.

A fine needle is used to inject the medicine near the occipital nerve, on one or both sides. You may feel a brief sting and some pressure. The injection takes only a few minutes, and there is no cut and no stitches.

Afterwards the back of your head may feel numb for a few hours. You can usually leave straight away and return to normal activities. The clinician will explain how soon any benefit might appear and when to expect to know if it has helped.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Occipital nerve blocks are generally well tolerated, and most side effects are minor and short-lived, such as injection-site soreness and a few hours of scalp numbness. The clearest uncertainty is how much and how long they help, which varies widely. Repeated steroid injections carry their own risks, such as skin thinning and hair loss at the site, so the use of steroid should be balanced against benefit.

Published figures to discuss

Occipital nerve blocks are generally well tolerated, and serious complications are uncommon. The main uncertainty is how well and how long they work, as much of the evidence comes from small studies. Reported side effects are mostly minor and local; figures for benefit vary widely and should be treated cautiously.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is usually no recovery time. 'Afterwards' is mainly about a few hours of numbness and then watching whether your headaches ease over the following days.

• Numbness over the back of the head for a few hours.
• Mild soreness or a small bruise at the injection site.
• A short-lived increase in headache in some people before relief.
• Variable timing of benefit, sometimes within minutes, sometimes over days.

Aftercare

• Carry on with normal activities; specific recovery is not usually needed.
• Be aware your scalp may be numb for a few hours, so take care with hot items near the area.
• Keep your headache diary to record whether and how long the block helps.
• Take simple pain relief if the site is sore, unless told otherwise.
• Watch the injection site for signs of infection.
• Know who to contact if you have unexpected or worsening symptoms.

• Confirm the type of headache and why a block is being offered.
• Tell the clinician about allergies, blood thinners and diabetes.
• Start or continue a headache diary.
• Plan to have someone with you the first time if you are anxious.
• Note pregnancy plans if relevant.
• Save the clinic contact route for questions or problems.

⚠ Get urgent help if…

• Spreading redness, swelling, heat or discharge at the injection site, or a fever.
• A severe or unusual headache that is different from your normal pattern.
• Signs of an allergic reaction such as facial swelling, widespread rash or wheezing (seek emergency care).
• New weakness, numbness elsewhere, slurred speech or vision changes (seek urgent help).
• A stiff neck with fever and sensitivity to light.
• Persistent dizziness or fainting after the procedure.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

When an occipital nerve block helps, people may notice less head and neck pain and sometimes fewer or milder migraine or cluster attacks. Relief can begin quickly from the local anaesthetic, and where a steroid is used it may build over a few days. The duration varies widely between people.

It is a symptom treatment rather than a cure, and it does not change the underlying tendency to headaches. A good outcome is a meaningful, if temporary, reduction in pain, and the block can be repeated if it helped. The evidence for size and duration of benefit is limited, so realistic expectations matter.

Any benefit from an occipital nerve block is temporary and varies a lot, from a short period to several months. The block can be repeated when symptoms return if it has helped. Where steroids are used, there are limits on how often they should be repeated to avoid local and wider side effects.

Related tests, treatments or support

Occipital nerve blocks are usually one part of a broader headache plan, alongside attack treatments, preventive medicines and lifestyle measures. They may be used while other preventive treatments are being set up, or in people for whom medicines are unsuitable. Your specialist decides how it fits with your overall care.

Follow-up & long-term care

You should be reviewed to see whether the block helped, by how much and for how long, which guides whether to repeat it. Make sure you know how the response will be assessed, who to contact with problems, and how the block fits into your wider headache treatment.

• Repeat blocks when symptoms return if they have helped, within safe limits.
• Keep a headache diary to track how long each block lasts.
• Limit how often steroids are used to reduce local and wider side effects.
• Review with your specialist whether continued blocks remain worthwhile.
• Combine with wider preventive measures as advised.

Repeat, follow-on and what comes next

• Blocks often need repeating as the effect wears off.
• If a block does not help at all, repeating it may not be worthwhile.
• Steroid use is limited in frequency to avoid local and wider side effects.
• Treatment may be changed to other options if blocks are not effective.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear way to record and review whether the block helped and for how long.
• Honest discussion of repeat treatment and steroid limits.
• A named contact route for problems such as infection or worsening symptoms.
• Integration with the rest of your headache care and your GP.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The clinician's fee for assessment and for performing the injection.
• Whether one or both sides are injected and whether a steroid is included.
• The clinic or facility fee where the procedure is done.
• How often the block needs repeating.
• Whether follow-up appointments to assess response are included.
• Whether the block is part of a wider headache management package.

• The cost per injection, including any steroid used.
• Whether assessment and follow-up are included.
• How often repeat blocks might be needed and their cost.
• What happens, and what it costs, if the block does not help.
• Whether communication with your GP is included.
• The cancellation and rebooking policy.

On the NHS? Occipital nerve blocks are available on the NHS in headache and pain clinics for suitable people; they are also offered privately, mainly for speed or choice.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Why is a nerve block suitable for my type of headache?
• Will you use local anaesthetic alone or add a steroid, and why?
• How will we judge whether it has worked, and how often could it be repeated?
• What are the risks for me specifically, especially with repeated steroid injections?
• How does this fit with my other headache treatments?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for occipital nerve block

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Occipital nerve block for headaches: a narrative review - PMC The Migraine Trust - Treatment options NHS - Cluster headaches (treatment options including nerve blocks) Brain & Spine Foundation - Headache (patient guide) NHS - Peripheral neuropathy / occipital neuralgia (nerve pain overview)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.