Occipital Nerve Blocks and Selective Nerve Root Blocks

OCCIPITAL NERVE BLOCKS

An occipital nerve block is a specialized procedure where a steroid or other medication is injected around the greater and lesser occipital nerves located on the back of the head, just above the neck area. At Vyvo Spine and Pain Management, we offer occipital nerve blocks to provide relief for certain types of headaches, including tension headaches and migraines.

Purpose of an Occipital Nerve Block

The primary purpose of an occipital nerve block is to reduce inflammation and swelling of the tissues surrounding the occipital nerves. By doing so, this procedure aims to alleviate pain and other symptoms associated with nerve inflammation or irritation. Many patients with headaches over the back of the head may find relief through occipital nerve blocks.

Duration of the Procedure

The actual injection itself takes only a few minutes to perform, making it a quick and efficient procedure.

Medication Used in the Injection

The injection consists of a local anesthetic, which provides immediate pain relief, and a steroid medication, which helps reduce inflammation and provide long-lasting relief.

Discomfort During the Occipital Nerve Block

While the procedure involves inserting a needle through the skin and deeper tissues, the discomfort is minimized by using a thin needle and numbing the area with a local anesthetic. While there may be some initial pain or soreness after the injection, it typically subsides within a day or two.

No Need for Sedation

Occipital nerve blocks are typically performed without sedation. The procedure can be done using a small, thin needle, and the local anesthetic within the injection provides sufficient pain control.

Performing the Occipital Nerve Block

The procedure can be done with the patient seated or lying down. The back of the head, including the skin and hair, will be cleaned with an antiseptic solution before the injection is administered.

Post-Procedure Expectations

Immediately after the injection, you may experience relief from your pain due to the local anesthetic. However, this effect is temporary and usually lasts only a few hours. You may experience some soreness or headache for a day or two following the procedure. The steroid medication takes a few days to fully take effect, providing more lasting pain relief.

Post-Procedure Recommendations

After the occipital nerve block, we recommend resting for a while before resuming your activities. Applying ice to the injected area can help reduce any discomfort. Most patients can drive themselves home and perform regular activities as tolerated.

SELECTIVE NERVE ROOT BLOCKS

During a Selective Nerve Root Block (SNRB), the targeted nerve is accessed at the point where it exits the foramen, which is the opening between the vertebral bodies. The procedure involves injecting a combination of a steroid, which is an anti-inflammatory medication, and lidocaine, a numbing agent. Fluoroscopy, a real-time X-ray imaging, is utilized to ensure accurate delivery of the medication to the intended location. If the patient’s pain subsides following the injection, it can be inferred that the specific nerve root that was injected is the source of the back pain. Additionally, the steroid component of the injection helps alleviate inflammation around the nerve root.

The success rates of SNRBs vary based on the underlying diagnosis and whether the injections are primarily intended for diagnostic purposes. While there is no definitive research dictating the frequency of SNRBs, it is generally considered reasonable to limit the procedure to a maximum of three times per year.

Performing SNRB injections requires technical proficiency and is more challenging compared to epidural steroid injections. Therefore, it is recommended that experienced physicians carry out these procedures. As the injection is administered outside the spinal region, there is no risk of a cerebrospinal fluid leak (commonly known as a wet tap). However, since the injection is in close proximity to the nerve root, there is a possibility that the SNRB may temporarily worsen the patient’s leg pain.