7901 SW 34th Ave

Amarillo, TX 79121

Victor M. Taylor, MD, DABA

Board Certfied Pain Management

Ph: 806-352-7431

Fax: 806-352-2374

Physical Rehabilitation in Chronic Pain | Opioids and Chronic Pain | Approach to Treatment

Occipital Nerve Blocks

 

What it is used to treat?

 

Headaches due to the Occipital Nerves.  Occipital Nerve Blocks are injections used to block nerves that travel from the cervical spine into the posterior scalp and used in the treatment of headaches.

 

What the goal/purpose?

 

The goal is to stop the occipital nerve from sending pain signals to the brain and to break the cycle of hyperactivity of the nerve.

 

What should I do to get ready for the procedure?

 

Stop taking any medication that thins the blood at least 5 days prior to the procedure. These medicines include Aspirin, and most over the counter pain medicines except Tylenol.   Read the list of medications that must be stopped that was given to you at your office visit.(should link to medication page)  Make sure it is ok with your prescribing doctor before you stop prescription blood thinners used for treatment of heart disease, peripheral vascular disease, irregular heartbeat or history of stroke.  It is your responsibility to clear this with your doctor.

 

Continue to take your other medications.  Do not stop blood pressure or diabetes medicines.

 

Do not eat or drink anything on the morning of your procedure. (link to preparation page) You may eat and drink afterward.

 

**On the day of the procedure it is important that you have a headache, so we can tell if blocking the occipital nerve gives you relief.  If you happen to wake up headache-free, simply call and reschedule.

 

How is it done?

 

Patients lay face down on the procedure table.  Monitors are attached to keep track of your vital signs during the procedure.  The area over the procedure site is prepped and draped in a sterile manner to protect against infection.  A fluoroscopic x-ray is then used to locate the target site.

 

The skin is anesthetized with lidocaine and using x-ray guidance a blunt probe or needle is advanced into the muscle layers of the upper cervical spine near the base of the skull or along a ridge at the back of the skull depending on the approach used.  Local anesthetic and dexamethasone is injected in the area around the nerve, and the needle is then removed.

 

After the test, you must stay awake for several hours to see if you received relief from the test.  We suggest going out to breakfast after the test and then doing activities that would normally not be possible.  Please call us 4-6 hours after the test and report your results

 

What is injected?

 

Lidocaine  or Ropivacaine are used along with dexamethasone.

 

Will it hurt?

 

Most people tolerate these procedures very well.  There is some discomfort associated with numbing the skin and there may be pressure during the injection.  Some patients require some sedation for the procedure, and others do not. The vast majority of patients tell us ‘that wasn’t so bad” or “I can’t believe I was worried about that;” however some people do find it painful and may require sedation.

 

Important Warning!

 

You may have some dizziness after an occipital nerve block.  Be careful when going from sitting to standing.  The injections sites can bleed lightly for several hours, so put a towel under your head if you lie down on your coach or other surface.  Call us if you have more than just a tiny amount of bleeding.

 

What is the chance of success?

 

Approximately 70%-80% of our patients get significant relief from this type of procedure.  Relief will consist of less severe and less frequent headaches. For some patients, headaches may be eliminated, but better controlled pain is more likely.

 

How often can the procedure be repeated?

 

These injections can be repeated 2 or 3 times over a couple of months.  If the procedure only gives short term relief, we can perform a pulsed radio frequency (link to pulsed RF) ablation of the nerve to try to get longer lasting relief

 

What can I do to maximize my chance of success?

 

Be consistent in your home stretching exercises.  Be consistent in using prophylactic medications as prescribed.

 

Why do I have a blue towel on the back of my head?

 

We place a sterile towel over the injections sites to absorb any mild bleeding and protect your cloths.  Remember the scalp tends to bleed so keep a towel under your head when you are resting for the rest of the day.

 

Why are there EKG pads still in place?

 

If you have thin skin or hair in the area, we may leave the EKG pads in place so that you can gently remove them with soap and water at home.

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