Occipital Nerve Block: Uses, Procedure, Side Effects, and How Long Relief Lasts
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is an occipital nerve block?
An occipital nerve block is an injection of anesthetic medicine, sometimes with a steroid, near an occipital nerve at the back of the head. It can temporarily ease pain from occipital neuralgia, migraine, cluster headache and neck injuries. It takes about five minutes, relief often starts within 20–30 minutes, and results vary between people. [1]
What the research says
Fast relief in migraine attacks, with weaker evidence for the long term. A 2025 review of 16 randomized trials (930 patients; 7 trials and 401 patients pooled) found anesthetic blocks lowered headache severity by a mean of 2.08 points at 30 minutes with moderate certainty. Weekly blocks on both sides cut chronic migraine by about 4.5 headache days a month at one month, with low certainty, and no serious adverse effects were found. (Atraszkiewicz et al., Cephalalgia, 2025) [2]
Clear short-term benefit for headache after a spinal puncture. A meta-analysis of 7 studies (275 patients) found pain scores were 4.23 points lower at 1 hour and 2.66 points lower at 24 hours with a greater occipital nerve block, and the risk of treatment failure was about 60% lower (relative risk 0.4). (Chang et al., Medicine (Baltimore), 2021) [3]
Adding a steroid did not clearly add benefit in chronic migraine. In a pooled analysis of 3 randomized trials, anesthetic blocks reduced headache frequency by 4.45 days in the first month compared with placebo, while adding a corticosteroid showed no significant extra reduction (1.1 days; p = .45); overall certainty was very low. (Velásquez-Rimachi et al., Acta Neurologica Scandinavica, 2022) [4]
Key takeaways
An occipital nerve block numbs one or more nerves at the back of the head to calm pain and nerve irritation. [1]
It is mainly used for headache disorders that have not responded to other treatments, and for upper neck pain and whiplash. [1]
The injection itself takes no more than five minutes, and most people go home after a short rest. [1]
Relief from a successful block usually begins within 20–30 minutes and can last from several hours to several months. [1]
Most side effects are mild and short-lived; serious complications are rare. [1]
What is an occipital nerve block?
An occipital nerve block is a type of nerve block in which anesthetic medicine is injected near an occipital nerve to give temporary pain relief and help settle inflammation from headaches or other conditions. [1] The injection sometimes also contains a steroid medicine. [1]
Your occipital nerves are a group of nerves at the back of your head. They come from the C2 and C3 spinal nerves in your neck ("C" stands for cervical, the neck part of the spine). [1]
Most people have two of each type, one on each side of the head. [1]
Which nerves does an occipital nerve block target?
An occipital nerve block targets one of three occipital nerves, each supplying feeling to a different part of the scalp. [1]
Nerve | What it supplies | Worth knowing |
Greater occipital nerve (GON) | Scalp from the lower back to the top of the head, the ears, and skin above the parotid glands | Largest of the three |
Lesser occipital nerve (LON) | Sides of the back of the scalp and the outer surface of the visible ear | — |
Third occipital nerve (TON) | Skin of the middle lower back of the scalp | Vulnerable to damage from whiplash |
Source: [1]
Irritation or damage to these nerves can sometimes cause pain elsewhere in the head, such as near the eye. Doctors call this referred pain. [1]
What does an occipital nerve block treat?
An occipital nerve block is usually used to relieve pain from certain headache disorders when other treatments have not worked. [1] These include:
Migraine, including chronic migraine [1]
Cervicogenic headache, pain felt in the head that starts in the neck [1]
Postdural puncture headache, a complication of a lumbar puncture (spinal headache) [1]
It can also help with:
Can an occipital nerve block help diagnose head pain?
An occipital nerve block can help your doctor find out whether your head or neck pain is coming from an occipital nerve or from somewhere else. [1] Knowing the source helps them choose the best treatment plan. [1]
How do you prepare for an occipital nerve block?
An occipital nerve block usually needs no special preparation. [1]
If your doctor recommends sedation, you will need to fast for six to eight hours beforehand and arrange for someone else to drive you home. [1] Follow your doctor's instructions, and ask any questions you have before the day. [1]
What happens during an occipital nerve block procedure?
An occipital nerve block is usually done as an outpatient procedure, so you are not admitted to the hospital and can go home shortly afterward. [1] The procedure takes no more than five minutes. [1]
Position: You sit with your head tilted down and supported by your hands, or lie face down with a pillow under your chest to bend your neck slightly. [1]
Sedation (optional): You may get a mild sedative through an IV line in your arm to help you relax. [1]
Finding the nerve: The doctor feels the back of your neck to locate the nerve, sometimes using ultrasound or fluoroscopy (live X-ray imaging). [1]
Cleaning: The skin on your neck is cleaned with an antiseptic solution. [1]
Injection: The medicine is injected as close to the affected nerve as possible. [1]
Rest: You rest while the medicine takes effect. [1]
What can you expect after an occipital nerve block?
Recovery time after an occipital nerve block depends on whether you had sedation. [1]
Situation | Rest before going home | Other notes |
No sedation | About 10 minutes | You can leave on your own |
With sedation | 15 to 30 minutes, watched by a nurse for unexpected side effects | Someone else must drive you home |
Source: [1]
What are the benefits of an occipital nerve block?
The benefits of an occipital nerve block include pain relief, calmer nerves and a clearer diagnosis. [1]
Not everyone gets pain relief from a nerve block, and you may need to try other treatments if it does not work for you. [1]
What are the side effects of an occipital nerve block?
The most common side effects of an occipital nerve block are pain, redness and swelling where the needle went in, which are usually mild and fade within a couple of days. [1]
Other possible side effects include:
If the injection contains a steroid, you may notice temporary hair loss (alopecia) and skin thinning (atrophy) around the injection site. [1]
What are the risks of an occipital nerve block?
Occipital nerve blocks are generally safe, and complications are rare. [1] Possible risks include:
Risk | What it means |
Bleeding | At the injection site |
Fainting | |
Facial swelling | Facial edema |
Worsening headache | Headache gets worse instead of better |
Swallowing trouble | Temporary difficulty swallowing (transient dysphagia) |
Nerve or artery injury | Damage near the injection site |
Infection | At the injection site |
Source: [1]
How long does an occipital nerve block last?
A successful occipital nerve block usually eases pain 20 to 30 minutes after the injection, and the relief can last from several hours to several months. [1] How well it works varies a lot from person to person and is hard to predict. [1]
For occipital neuralgia and cervicogenic headache, lasting relief may need a series of several injections. [1]
When should you call your doctor after an occipital nerve block?
Call your doctor right away after an occipital nerve block if you develop any new symptoms or complications, such as signs of infection or nerve problems like burning pain, weakness or tingling. [1]
Occipital nerve block at a glance
Question | Answer |
What is injected? | Anesthetic medicine, sometimes with a steroid |
Where? | Near an occipital nerve at the back of the head |
How long does it take? | No more than five minutes |
Hospital stay? | No — outpatient; home after about 10–30 minutes of rest |
When does relief start? | Usually 20–30 minutes after a successful block |
How long does relief last? | Several hours to several months |
Does it work for everyone? | No — results vary considerably |
Source: [1]
Conclusion
An occipital nerve block is a short, generally safe injection that can calm pain coming from the nerves at the back of the head. It is most often offered for occipital neuralgia, migraine, cluster headache, cervicogenic headache and neck injuries when other treatments have not helped, and it can also show your doctor where your pain is coming from. Relief can arrive within half an hour and last for hours or months, but it does not work for everyone, and some conditions need a series of injections. [1]
Bring this to your next appointment. If headaches or upper neck pain keep coming back despite treatment, ask your doctor whether an occipital nerve block fits your situation, whether a steroid would be added, and how many injections they would expect. To learn more about what may be behind your pain, explore our guides to headache types and triggers and nerve blocks for targeted pain relief.
FAQ
What is an occipital nerve block?
An occipital nerve block is an injection of anesthetic medicine near an occipital nerve at the back of the head to give temporary pain relief and calm inflammation. The injection sometimes also contains a steroid.
What conditions does an occipital nerve block treat?
An occipital nerve block treats headache disorders such as occipital neuralgia, migraine, cluster headache, cervicogenic headache and postdural puncture headache. It can also ease upper neck pain and whiplash, and doctors may use it to find the source of head or neck pain.
Does an occipital nerve block hurt?
An occipital nerve block takes no more than five minutes, and the most common after-effects are pain, redness and swelling at the injection site. These are usually mild and fade within a couple of days.
How long does an occipital nerve block take to work?
An occipital nerve block usually starts to ease pain 20 to 30 minutes after the injection when it is successful.
How long does an occipital nerve block last?
An occipital nerve block can give relief lasting from several hours to several months, but results vary a lot between people. Occipital neuralgia and cervicogenic headache may need a series of injections for lasting relief.
What are the side effects of an occipital nerve block?
The side effects of an occipital nerve block include soreness, redness and swelling at the site, dizziness, vertigo, numbness and lightheadedness. Steroid injections can also cause temporary hair loss and skin thinning around the site.
Can I drive home after an occipital nerve block?
After an occipital nerve block with sedation, someone else must drive you home. Without sedation, you usually rest for about 10 minutes and can then leave.
When should I call my doctor after an occipital nerve block?
Call your doctor right away after an occipital nerve block if you notice new symptoms or complications, such as signs of infection, burning pain, weakness or tingling.
How often can you get an occipital nerve block?
Occipital nerve blocks can be repeated if they help. Your doctor will space them out, especially when a steroid is included in the injection.
Can you go back to work after an occipital nerve block?
Most people return to normal activities the same day or the next day. If you had sedation, plan to rest for the rest of the day and have someone drive you home.
Related Reading
Occipital Neuralgia: Understanding the Sharp Pain of Scalp Nerve Inflammation explains the sharp scalp nerve pain these blocks often treat.
Understanding Nerve Blocks: A Comprehensive Guide to Targeted Pain Relief explains how nerve blocks work and the main types used.
Migraine Headaches: What Causes Them and How to Treat Them covers migraine causes, triggers and treatment options.
Cluster Headache: Understanding the Most Painful Headache, and What Treatment Can — and Can't — Do explains cluster headache symptoms and how attacks are treated.
References
Cleveland Clinic. Occipital Nerve Block. Cleveland Clinic. Last updated May 1, 2023. https://my.clevelandclinic.org/health/treatments/24934-occipital-nerve-block
Atraszkiewicz D, Ünal E, Bassett P, et al. Greater occipital nerve block for the treatment of migraine: An umbrella review, systematic review, and meta-analysis. Cephalalgia. 2025;45(12):3331024251398390. PMID 41329694. https://doi.org/10.1177/03331024251398390
Chang YJ, Hung KC, Chen IW, et al. Efficacy of greater occipital nerve block for pain relief in patients with postdural puncture headache: A meta-analysis. Medicine (Baltimore). 2021;100(51):e28438. PMID 34941197. https://doi.org/10.1097/MD.0000000000028438
Velásquez-Rimachi V, Chachaima-Mar J, Cárdenas-Baltazar EC, et al. Greater occipital nerve block for chronic migraine patients: A meta-analysis. Acta Neurol Scand. 2022;146(2):101-114. PMID 35726455. https://doi.org/10.1111/ane.13634
Medical disclaimer
This article is for general education and does not replace advice, diagnosis or treatment from a qualified healthcare provider. Always talk to your own doctor about your symptoms and treatment options. If you have sudden, severe or unusual head pain, seek urgent medical care.
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