Sunday, May 23, 2010

Occipital Nerve Block

On Friday I had my first occipital nerve block. *Update - I'm referring to the procedure described below as an "occipital nerve block" which is what the doctor who performed it (an anesthesiologist), called it. If you read the comments below, you'll see that "occipital nerve block" could mean different procedures to different doctors. As always, please talk to your doctor and do not make medical decisions based on my blog posts. Thank you!* If you're not familiar, here's a description in Q & A format (note that I do not go to this medical provider; it was simply the best description I found via google). Forgive me if this explanation is not entirely medically accurate - it was difficult to tell what exactly was going on during the actual procedure because my head was turned away; plus the pain clouded my thinking!

My husband had to take me to the appointment because I wasn't allowed to drive home. Once I got there, my vitals were checked and I went to the first room. I filled out a general headache questionnaire and then a nurse (not certain about the title) inserted an IV in my hand "in case" they needed fast access in case something went wrong. Nice. Then the anesthesiologist came in and had me sign a consent form. I had to replace my shirt with a lovely hospital gown, and then they had me go to the procedure room.

Talk about intimidating! In the procedure room were three different people with surgery masks, aprons and hair covers. A tech had me put my hair up and she put a hair cover over me. Then she had me lie down on the exam table in the middle of the room and turn my head to the left because I was having my right side done. The door and all the action was on the right, so the only thing I saw the whole time was the X-ray tech making adjustments to the machine above me. After what seemed like forever, the anesthesiologist came in the room and I couldn't turn to see him because they already had me positioned properly. He marked the spots on my neck with a marker and then covered the entire right side of my face and neck with a sheet of plastic, I'm guessing so germs wouldn't get in the area during the procedure.

Finally, the shots began. The first was Lidocaine which numbed the skin. Then the real pain began. I couldn't feel a lot on the surface, but from what I could tell the anesthesiologist inserted three needles into the appropriate spots, which hurt pretty bad - not from the needles penetrating the skin but from them going into my neck muscles where many of my headaches seem to start. The sudden stabbing pain plus soreness made me want to groan in pain but held it in. The tech (not the X-ray tech but another one) was holding my hand the whole time, and at this point I gave it a slight squeeze and took a deep breath. Next the anesthesiologist said it was time for the injections. The pressure was also fairly painful, but it was quick. Finally it was over, and I was helped into a wheelchair and taken to a recovery area.

One of the nurses gave me a soda (I asked for Sprite since I've eliminated caffeine and aspartame, which ruled out the other options. I've added citrus back to my diet and found that it is not a migraine trigger, thank goodness). After sitting a few minutes and changing back into my shirt, the nurse removed my IV and walked with me to the waiting room where my husband was patiently waiting. I was dizzy and my balance was thrown off because the right side of my head/neck was numb, so I asked him to stay close to me. We were out of there in an hour-and-a-half, but I'd guess the actual procedure took no more than five minutes.

So has it worked? Well, I'm not sure yet. On Friday it hurt to move my head at all, and yesterday I felt like I had whiplash. I've been icing it and resting, and it's not nearly as sore today. I still am having slight headaches on and off, and they still seem to be all over my head. The effects of the steroid are usually felt three to five days following the procedure, so I'm patiently waiting.

Here's a picture of my neck. Note that the purple is the marker, or at least that's my guess since there was some purple on the band-aids when I took them off.


I'll do an update soon on whether or not my headaches have improved. Here's hoping they do!

88 comments:

steph said...

Thanks for sharing your experience!

:)

Parin Stormlaughter said...

Wow...take it easy, hon. The way you described it, seemed like I was there. Would've given me "white-coat" hypertension at least! You're a trooper for sure.

Your right side got the shots - is that where you get most of your head pain? My right ear is the one with the worst of my Meniere's problems. Wonder if an occipital block might help with the ear pressure and tinnitus on that side? I might ask my neurotologist when I see him next time.

I hope beyond hope that this does the trick for you. *hugs*

Diana Lee said...

Wow, talk about an intense set up. My injections weren't given in that kind of setting at all and it was scary enough. I really hope they give you some relief. Take care. :)

WinnyNinny PooPoo said...

I'm with Diana Lee, they just said let's try this, leaned me over while I sat in a chair, and Boom Done! No driver, no anethesiologist or anything. Sounds like they were a lot more careful with you.

Mine only lasted about 2 hours, so sounds like you are maybe going to get better use out of yours!

Banner said...

Wow!!! I've never heard of such a process for the injections! Mine were like Winny said...I just sat in a chair in my doctor's office, she made a few injections in my head, and that was that.

Nonetheless, I hope they give you some relief.

MigrainePuppet said...

I hope the shots really help you. Thank you for sharing your experience. Good luck!

Heather said...

Parin - I actually get pain on both sides, but if I do have it on just one side (which is rare) it's generally the right side. I'm not sure how it would help with your pressure/tinnitus, but your neuro should know. It's worth a try in my opinion!

Dianna Lee, Winny & Banner - I've had a quick injection in my head done by a former neuro (also when I was sitting in a chair in his office), but I think it was just a Lidocaine shot (and it didn't work at all). Maybe that's what you had done, and not a full "occipital nerve block"? Either that or my docs are much more dramatic than necessary lol. ;)

Everyone - thanks so much for the well wishes. Unfortunately it's been five days and I'm still having bad headaches, on both sides. It's too discouraging to put into words, so right now I'm just trying to find out what I can try next.

WinnyNinny PooPoo said...

:( I was told either you get relief from injections or you don't. Sounds like you are on the "don't" side from this. I also tried trigger point injections.

You are right I didn't receive steroids by my request, but the procedure would have been the same, just different meds in the needle - the neuro said she does these all the time at her office...different docs, different methods - they generally charge plenty $$ per injection series, some insurances call it a type of surgical procedure.

Heather said...

Winny - "Different docs, different methods" could not be more true! I guess that's a good thing because it gives us patients more options. My insurance - United Healthcare, which is yours too now if I remember correctly - said they would cover 100% after the $40 copay. Let's hope they keep their word, or else I'll be declaring war on them in addition to my headaches!!!

Anonymous said...

Good luck with that... UnitedHealthcare told my Doctor's office the same thing so I had it done twice before I got the bills. When I told them that the office called first they said that they couldn't approve that over the phone and now I'm stuck with the bill and my headaches.

Heather said...

Anon,

Please fight them if you can. I had a UHC claim that said they denied it and called them and my doc's office, but my doc didn't know about the claim so I'm waiting for the bill from them...once I receive it I'm going to have the doc call UHC or share their notes to show that I needed the procedure. If they still don't cover it I'm going to appeal, appeal and appeal again, until I win.

Good luck to you too!

monkeymama said...

I have done the wham bam thank you maam occ block in the ofc. It worked for a month the first time 6 years ago. Over the years, I've had little success with them.

Anonymous said...

I just had my nerve block done on Friday. Very "wham bam" and it was quite intense. The experience was strange enough but my recovery has been awful!! Now going on Day 4 of varying levels of pain in my neck, shoulders, head and back. I felt at first like I'd been hit by a truck... now I just have intermittent pain and "ice cream" headaches if I get up too fast. This has NOT been fun at all...

Hope yours works for you and mine had better work for me, after all this!

Carrie said...

I have my block this friday, in the doctor's office and I my nerves are on edge. I've been dealing with these migraines for 13 years on pretty much a weekly basis. I am praying this works for me! Their next recommendation is seeing a pain mgmt dr for a Rhizotomy. Thanks for sharing your experiences with me!

Anonymous said...

My six shots were all sitting in the chair, too. Both the "trial" and the steroid ones. Did have a driver, but no monumental effects, besides injection-site pain, after the numbing agent wore off. I notice a difference in how quickly the sensation returned when the steroids were added. I assume they used less numbing agent?
Had my trial shots last week, and real ones today, BTW.
Also, mine were all in my scalp, not my neck. That looks painful, and why the theatrics with all the prep & staff?

Anonymous said...

Hi! My name is April I I came across this while googling nerve blocks becuase I am having one today for the first time. It sounds like you may have what I have, occipital neuralgia. It is very common for one side to hurt worse. I have spent thousands of dollars finding this diagnosis and thought I would share so you could look into it. God Bless! my email is aprilsurratt@comcast.net

Tristan said...

Hi, I am a Cluster headache sufferer.

I see a few people here having the nerve block fitted, do you have an update, has it helped?

If anyone has any tips or feedback let me know here or via lawrence73@hotmail.co.uk

Anonymous said...

WOW and I that mine hurt....
I do have a Question???
I was told by one of my docs that your only allowed 3 shots a year???
next month I'm seeing my other doc ( on the side ) for shot number 4 on both side of the back of my head..... Is there a down side to this?
Thanks
Jim
my email is
Jimmym101 @ AOL.com

Heather said...

Thanks everyone for your comments! Unfortunately the nerve block did not help me, but that's not to say they don't help others. Good luck to you all!

Anonymous said...

Has anyone had a positive experience?

buy generic propecia online said...

I have always felt that blogging has been an art where people express their experiences in the best manner.This is something that is very informational.

Anonymous said...

I am supposed to have a nerve block done next week on the occipital area but after reading your blog and comments I am petrified!! I agree, has ANYONE gotten relief from these? is it even worth it"??

Anonymous said...

Hey everyone my name is christie...I have had brain surgery three times and since then have been in horrible pain. My doctors recomended the nerve block for me. I did it back in August-It worked and from what I hear its a hit or miss depending on what nerves they go into on your neck so it can take several times to find the right nerves.

My thing is that this procedure was SO extremely painful!! I have had several spinal taps and this was far worse than those!! I had no type of sedation or warning that this was going to be so painful, dont get me wrong I knew it would hurt but the person who drove me was in the waiting room and could hear me crying from in the waiting room.

Now the block is starting to wear off and im not sure I can ever have this again...How are you all dealing with sitting through this procedure after the first time?

Anonymous said...

Hi I had both an occipital nerve block on both sides and trigger point injectionsin my trapezius two days ago - The only info I had was that it was going to hurt - but just to reassure anyone who is having it - I gave my consultant 10 out of 10 - the trigger points were nothing more than a sting and the nerve block was a little crunchy when the needle went into the scalp but certainly not agony and only a little uncomfy - I would have it again. Has it helped my migraine - too soon to say - I have a very slight background headache at the moment but the doctor said that a 30% improvement is a success and I think that most people would really appreciate that percentage of improvement so will let your know. Brenda

Anonymous said...

wow, Ok I had mine done on the 8th of nov.. I had around 25-27 shots only two were nerve blocks the rest was trigger point work. Now They didn't even give me warning, I was just sat in a chair in the office, and they went to town, no IV no nothing, and the two knobby things (can't remember term) in the back of my head is what was shot lol. Well it is now the 19th and still no pain relief, grr. I called the office and the receptionist said it would take two or three weeks to work.......really? she said I will just wake up one day and the pain will be gone.....really? I hope so but I need to know from just a curious point if you or any of you were told this. AND if yours worked, how ling after you received the shots did it work? Take care and I hope you got some relief! -Nicole

Anonymous said...

wow, Ok I had mine done on the 8th of nov.. I had around 25-27 shots only two were nerve blocks the rest was trigger point work. Now They didn't even give me warning, I was just sat in a chair in the office, and they went to town, no IV no nothing, and the two knobby things (can't remember term) in the back of my head is what was shot lol. Well it is now the 19th and still no pain relief, grr. I called the office and the receptionist said it would take two or three weeks to work.......really? she said I will just wake up one day and the pain will be gone.....really? I hope so but I need to know from just a curious point if you or any of you were told this. AND if yours worked, how ling after you received the shots did it work? Take care and I hope you got some relief! -Nicole

Heather said...

Nicole,

I wasn't told that, and I hadn't heard that you could just wake up one morning and the pain would be gone. I'd be skeptical of any doctor who claims that would happen. Might be time to find a new doc (just my opinion)!

-Heather

Anonymous said...

I am sorry to intrude on your blog but I feel I must say something regarding the occipital nerve blocks.

To anyone considering this treatment, do not let this account of the procedure deter you. I showed it to my neurologist after he suggested the blocks to me and I told him I was too afraid. He told me what she had was not a occipital nerve block. Upon further research, I cannot find ANY descriptions of the procedures that is anywhere close to this bloggers account.

That being said, I had the blocks a week ago. Cortisone and lidocaine. It was two injections, one on each side directly on top of the nerve. (the injections in the bloggers photo are no where near the nerve??) No anesthesia, no IV, no procedure room, no gown, hair net, etc. It was a simple procedure in the doctors office. There are YouTube videos that show the procedure...its very straightfoward. Its likely the blogger had facet injections or something similar. Not occipital nerve blocks.

If your doctor still insists you had occipital nerve blocks, I would get a second opinion. Again, I'm sorry to intrude but your blog is the first thing that comes up when I Googled Occipital Nerve Blocks. It almost kept me from getting a procedure that is actually turning out to be very helpful. And was no where near what you described.

Best of luck to you.

Heather said...

Anon,

I appreciate your comment. I certainly do not intent to deter anyone from getting occipital nerve blocks which may be helpful. I've always said that something that does not help me might help someone else, and vice versa.

A former neurologist of mine did a lidocaine injection in my head once, and it sounds like what you're describing. I told him I had a headache and on the spur of the moment he decided to go for it, and all he did to prep was move part of my hair aside and swab it with alcohol and then he injected the needle...it was pretty simple and painless. Maybe some doctors refer to that as an occipital nerve block.

I can say for a fact that my current neurologist calls what I described in this blog post an "occipital nerve block" and I go to a very reputable clinic. Perhaps occipital nerve blocks can mean more than one thing or can be performed different ways.

Again, please don't be swayed by my post. I'm simply putting the facts out there, and I am confident that my readers are mature and educated enough to make their own decisions or to bring up their concerns to their neurologists, like you did.

Anonymous said...

I've had four medial nerve ablation procedures done, two on both sides. They injected C3,4,5,&6 with a numbing agent after which an electric current was led to the nerve to kill it. The procedure was done in a surgical center under a phlorscope and IV conscious sedation by a pain management specialist doctor, not a neurologist. It was really fine because of the sedation and local anesthetic and because I don't remember much about it.
They have helped my head aches for 6 months at a time. However, after the last procedure, I am again getting almost daily headaches and am now considering Botox shots and possibly, ONS aka occipital nerve stimulation transplant. I had an occitipal block done in the pain doc's office but nowhere near the area that shows in your photo. The shots were done in the back of the head and were not too uncomfortable. So I don't know what it means that two different procedures seem to have a similar name. Best of luck to you.

Chuck said...

Thanks for sharing your experience. I have had daily "background" headaches for 18 to 20 years and have frequent migraines. ONB was suggested to me by a friend, but as of yet I've been hesitant to try it. Good luck and thanks again.

Chuck Hebert

Anonymous said...

I've had an ONB twice now and it was a very easy procedure. A light sting (very minor and to be expected with any shot)followed by some crunchy sounds (that didn't hurt) and apparently is the ligaments in the neck. I get about 3 months relief from migraines and had NO after-pain whatsoever from the procedure. From the horror stories some have mentioned in here I have to wonder if we are talking about different procedures.

terry said...

Wow I am going next week to get this procedure. My doctor will be doing it in his office on both sides of my head. I am hoping it works.

I don't know if anyone has tried Botox...I am also having my 4th series of Botox shots and they do seem to offer some relief but my neurologist only does them in my forehead. It is expensive and sometimes insurance pays for it. I am VERY lucky that my insurance has covered all costs for the Botox.

Good Luck Heather and God Bless...

Heather said...

Terry,

Wow that's a good sign that your insurance (occasionally) covers Botox, AND that it's helping! I hope to try this once my insurance covers it. Good luck to you too. God bless!

R said...

6 days ago my wife had the Occipital Nerve block injections on both sides of her head, way up in the hairline (pretty much just as shown in the you-tube videos), the needles went in just at the base of the skull, with the point of the needles aimed "up" into the head/top of vertebrae area.

They were extremely painful injections, she tried not to cry/scream but the last 3 were too much, but the Doc told her she was a trooper and had done very well anyway as it was a most painful procedure and he was proud of her. The whole thing lasted maybe 10 minutes. For 4 days just the pain at the injection sites were overwhelming, then by the next day the constant headaches were gone.

1 day later she started experiencing a different head pain, only on one side this time, sharp, jabbing pain up inside the top, right side of her head, almost like migraines, but not constant; neither does it respond to either triptans or Oxygen, as her migraines and/or Cluster headaches would. I will call her Doc in AM and find out what he wants to do.

Oh, my wife has severe allergic reactions to most oral meds (Stadol nasal mist is all she had to help avoid ER visits - she has no insurance) and 2 months ago they gave her botox shots in both traps (shoulder muscles) as her pain involved her neck, head and face/jaws and 8-months of laser/massage/exercise therapy were mostly useless.

After about 2 months (they did both shoulders 3-weeks apart) the pain in her face/jaws was gone, but the neck and head pain remained and this is why the Doc suggested the Occipital Nerve Block.

Her pain problems started after being hit by a car which drove into the restaurant where we were eating so the car insurance is paying the bills- (I am leaving out my problems as this blog is about Occipital Nerve Blocks and so far the triptans seem to work on half my headaches and I have pain meds for the new neck pain.)

I will let you know what happens with my wife when we find out more. Good luck to all of you. If you are in need of prayer (which works, BTW) let us know.

(PS - I am a disabled soldier who has had numerous nerve-blocks of various types up and down my spine plus C4/C5 Fusion surgery using a piece of my hip. The surgery gave me relief for about 5 years before the discs above and below began to crumble; I refuse the surgery in the lower lumbar region as it will involve inserting a metal rod and fusing most of my lower vertebrae. I used up most of the allowed nerve-block injections as each injection lasted less and less time until I had used up the max allowed. So I live on pain pills (Methadone, Oxycodone, Morphine Sulfate; plus Valium for muscle spasms; every few years meds get changed by a new doc.) It is not a life I want for my wife, nor would I wish it on anyone else, but after many years of PT, shots, massage, chiropractors, etc, I get most pain relief from Japanese magnets and the pain meds from the VA - not total pain relief, I can't imagine what that would be like anymore, but enough to be able to get up and go for a walk most days - both knees are also shot - 12-knee surgeries later and I refuse knee replacement until I cannot walk at all -{avoid jumping out of aircraft weighing 2X your body weight, over and over as it is "bad" for your knees and spine, which when we are young we don't listen to good advice very well, if at all anyway - at least I obviously didn't}

Whoa - got carried away here - sounds like I was maybe venting?? - SORRY!

I'll let you know about my wife though.

Teri said...

I have suffered from Migraine headaches for over 20 years. I suffer from migraines on a daily basis. As long as I take my Relpax medication daily, they are under control. I thought I had tried it all. My insurance (UHC) finally backed me into corner where I was forced to look for other solutions (appeals process doesn’t work unless you can prove you’re going to die). I saw a Pain Management Doctor last Thursday for the first time and he gave me an injection on the left side of head at the base of the crown near the spine. He told me this was only a test and the effects would only last a few days. He explained that if the medication worked I would probably experience headache pain similar to normal headaches but a little more intense. He said I could take ibuprofen and that it should take care of it. The shot did hurt but not too bad but I was sooo sore for about a day and a half at the injection site and down my neck. After two days of taking the ibuprofen, I had two days without any medications what so ever. For me it was a miracle. I called the doctor back and told him that they worked and I went back in this morning and got two injections. One for the left side of my head and one for the right side of my head. He said that this procedure really only works for the type of headaches that I described. My headaches always start at the back of head (on the left or right) and work its way around to the front of my head and eye socket and eye brow. Sometimes my ear and jaw. I sometimes get nauseas but I’ve never thrown up. I just couldn’t believe that I actually found a solution after trying all the migraine medications (which work but I need to take them daily and UHC won’t pay), the medication preventatives, the MRI’s and Cat Scans, the neuro muscular therapy, chiropractic visits, C5 spine fusion, acupuncture, pain killers, physical therapy, eye exams, hearing tests, dental work, diet changes and hormone replacement. Overall I’m a healthy individual. I’m not over weight, I eat very healthy, I go to the gym regularly, I’m not depressed (you’d think I would be after all this time) I get regular well women checkups and have no disease or handicaps or defects. After my infections this morning, my neck is really hurting but I just took three Ibuprofen and I think that will settle it down. The doctor also mentioned that there is another procedure which was describe by another blogger where they kill the occipital never but he didn’t want to go there if he didn’t have to. He said the steroid that was injected was to make the shot last longer (up to 3 months) and I forgot the name of the nerve numbing medication that it was mixed with. He said I wouldn’t have any side effects and that he would only recommend the shots 4 times a year. He said it was safe for long term use. So far I am very very happy and very very hopeful.

I wish everyone the best in finding a cure that works for them and my thoughts and prayers are with you all. If things change I’ll blog back

Heather said...

R - thank you for your service, and I'm sorry for your injury. It's awful that your wife was hit by a car while in a restaurant...that's not something you would normally expect to happen!! I'll be praying for you and your wife.

Teri - sounds like we've tried a lot of the same things. I'm happy the nerve blocks work for you! Thank you for your prayers.

Anonymous said...

Sounds to me like you had facet nerve blocks. I have had occiptal nerve blocks, trigger point injections, botox injections, facet nerve blocks and nerve ablation. No relief from any procedure. Sure the docors have all my money and I have headaches that are debilitating. I often think death would be better than suffering like this everyday. I spend 98% of my time in bed or in the damn recliner.

Linda said...

I had that procedure done today both side of head around 1:30pm and between 5:00 pm and 6:00 pm I got a headache on both side of my head. The doc. said that I would not have a headache for 1 month. What gives. I still feel that I have tension headaches and not migraine. Docs. never listen.

Heather said...

Anon - I'm so sorry nothing is working for you and that they're so debilitating. I'll say a prayer for you. It's tough when you're in pain, but try to stay hopeful and enjoy the little things in life. :)

Linda - maybe it will take a while to work. I was really stiff days after my block (of course it didn't work either way).

Anonymous said...

I just got my first occipital nerve block injection yesterday, and thought i'd share my experience. I have terrible migraine headaches, and have suffered for years. Yesterday I had one so bad my eyes were watering and I could hardly carry on a conversation... I happen to work for a radiology group who own an outpatient imaging center and also provide pain management services. I asked one of our doctors about injections and he suggested the occipital nerve block. He also suffers from migraines and gets these done too. I trust his opinion and so proceded with the injection, which he administered. Here's what happened:

I changed into a gown, and went into a sterile room. The nurse had me sit down on a stool and lean forward, resting my head on my arms on top of a pillow on the table. The doctor came in and prepped the area with iodine, and then injected lidocaine into the trigger areas at the base of my skull. He kept me informed of what he was doing, which helped my anxiety (I hate needles)... the lidocaine injection felt like a pin prick and then it was numb so my head felt a little strange. There were two done on each sideof my head.

Next, the actual steroid was injected. Two on each side of the base of my skull. I did not even feel them. The nurse then cleaned the iodine off my neck and I was done.

The entire procedure probably took 5 minutes. I had a good doctor who does these all the time and had a positive experience with the actual procedure. My head felt numb and heavy from the lidocaine, but my headache was noticeably less painful immediately.

After a few hours, the numbing wore off but my head was a bit sore at the injection site ( this is normal)... however my migraine was completely gone. I was told this should last about 3 months. So far, so good...

Anonymous said...

Sorry to clarify on my post above - the RELIEF should last for 3 months.... the soreness is less today. Just a little tender. Hope this helps! If you are in Nashville, i'll be happy to recommend my doctor. :)

Heather said...

Anon - I'm happy to hear the nerve block worked for you! I hope you continue to have relief. :)

ally * said...

im 16 years old & i have a cerebral aneurysm, pituitary tumor, and occipital neuralgia.
-- i just had my 2nd round of shots on wednesday. so far ive only had relief for up to 45 min. after ! im considering having surgery instead of the shots every month. any advice ?

jz said...

hmmm. I have been going to pain management for 9 years now. For many reasons, including a complete cervical fusion/corpectomy of 5 levels of my neck. I suffer from terrible bouts of headaches that begin at the base of my skull. They completely knot up the indentation there, then spread up over my head into my eye and all over the right side of my skull. I have had two occipital nerve blocks, neither of which were injected where your marks are. Both were done in my doctors office by him and his nurse. One shot of lidocaine which numbed just the back of my head, and one shot of steroids along the nerve. Which btw is located also in that depression at the base of the skull. My headaches would occur on a daily basis, and be so bad as to make me sick and put me in bed. I slept more often then not, with a cervical collar to immobilize the muscles in my neck. The first procedure lasted almost a whole year until I fell down the stairs. Seemed to have jerked my neck bad enough to start the pain again. Only this time tooth and ear pain joined the headaches. Went in for my monthly visit, asked if we could schedule me for another nerve block, he offered to do it on the spot since there were no other patients waiting at the moment. Took 5 minutes with my head looking down through a hole like on a massage table. Pinned up my hair with a hair clip. Left my clothes on. Cleaned the neck area with something cold, got the lidocaine, got the shot. Immediate relief. I also got a temp. IV, "just in case" but no worries. I then drove to do my once a month shopping. I admit my head felt weird at the back numb. But I was not dizzy and had no other ill affects. You may want to try talking to a few pain management doctors. They aren't all good. I do hope you find relief.

Anonymous said...

I had my shots done this morning for occipital nuralgia I have been getting them since since july2010 and this is my 3rd set I get both sides done and have always had relief from them. Its a office visit done by my nuro dr an alchol swab and a single needle he mixes the steroid and the local so it's a single stick on both sides.(just above the hair line) No pain really just a wierd feeling. We chat a few min in his office then I drive myself home.I'm a little stiff the day of and after the shots almost like I slept on the couch but heat and tylenol help this and I have gone back to work after leaving the office. The stiff neck is a very small price to pay for months of headach free days imo. Hope this helps.

Tracy said...

I have had 5 ONB's since Dec, but only one of them contained steroids. I've researched a lot about ONB's & some Dr's do them with steroids all the time & other Dr's use a solution that is a type of a long term numbing agent when doing the nerve blocks. Then of course some Dr's do a more permanent procedure by damaging the occipital nerve. All of these are refered to as occipital nerve blocks. I think that is why so many people are in disagreement about what a ONB is. Actually the 1st ONB I was told I had done was nothing like anything I've ever read or anything you guys have described or anything like what my current Dr does. What I have done now looks somewhat similar to the one on YouTube but with no numbing of the skin & only 1 needle & 1 solution. Sometimes it is helpful & sometimes it is not. So my advice is don't give up on it if it doesn't work the 1st time. I'm glad I didn't. And to the person in Nashville who is your Dr. I wonder if we have the same one. Goodluck to everyone! I've had these things for about 7 years & I still struggle every day. My heart goes out to anyone who deals with it also.

TrishKF said...

I had my first occipital nerve block last week friday and it has been the best thing of my life! For the first time in 10 years I have been headache free. Hope it lasts! If it does wear off - I'll be signing up for another one. The pain is sorta intense for a moment, but the procedure really is fast...took like a minute. And I didn't need a driver or anesthesiologist or anything like that - thank goodness!
Good luck to everyone

ryan said...

Heather. From looking at the landmarks, it is possible that certain branches of your occipital nerve could have been missed. I will suggest a follow-up consult and consider another series of injections that utilize the landmarks as the Occ. N. courses upward from the occipital protuberance. One can see these nerves via ultrasound...

Cheers,
"Pain Practitioner Suffering from Migraines"

Heather said...

Ally - I'm not comfortable giving advice when it comes to something as drastic as surgery, sorry! I'll pray that you and your docs make the right decision. So sorry you're dealing with this at such a young age!

JZ - glad it worked for you! I go to a clinic tied to a very well known hospital, so I trust that they did the best they could. Because the steroid affected my hormones, I'm done with this type of treatment!

Brigid said...

Heather, i'm so sorry to hear of your struggles with your migraines. I too have had them, about 20 years now, and today I had a occipital nerve block for the third time in my life. I am also a lab technician and know a lot about various health issues. The occipital nerve block only works if your occipital nerves are involved. If it is not working for you, then it's not the occipital nerve, causing your headaches. The procedure should be quick with your neurologist injecting your neck for about a minute or two. I was reading what you went through, and was feeling horrible for you. I have never been through that during an occipital nerve block, again I felt awful for you. Also what some peole may not realize is that the steriods don't start working for 3-7 days after the block, so they may not start feeling relief until then. Even though the nerve blocks help me slightly, I still 20 years later are taking zomig to treat my migraines. No one has been able to stop my migraines for 20 years, and I don't think anyone ever will. Hopefully you have a good family/friends suport team, to help you deal with your migraines. I will pray for you, that you're not in pain anymore, and that you find a solution for your migraines. All my best, Brigid

Heather said...

Brigid,

Thank you so much for your prayers, they are still very much needed. I will pray for you as well! :)

StoneCry said...

I've been recommended a ONB by my neuro yesterday. Over 20 years of chronic migraines and daily headache. I'm very nervous about the pain, but don't like the pain I'm in. I'm not sure what to do. I guess prayers are in order for the most part; God's leading will be what I need certainly. Also, His peace should I move forward with this procedure. After all this time, I'm so tired of trying out all the different meds; seems I get all the severe side-effects (even if I don't read the side-effects before-hand). I'm also tired of the constant pain.

StoneCry

Brenda said...

My husband is suffering from headaches from the occipital nerve as well. He fell 3 months ago today and hit his head on a brick wall and sufferend whip-lash, which inturn has resulted in this ongoing condition today. He has had PT for the whip-lash with no progress at all. My husband also has a 100% occulssion (blockage) in the back of his neck/head that is in-operable, thus pt has no great effect due to the limitations re: the blockage. He is now waiting on a phone call to go see another dr. for another opinion. To date, there has been no medications, and he's been on several, that have been able to take away all of his pain. The current specialist he is seeing has mentioned a nerve block..we don't really know what other opinion he has but to let them try this next...any words of wisdom, whould be greatly appreciated...btw, we live in central pa, if that's a question to anyone for whatever reason. Thanks.

Brenda said...

3 mths ago today my husband fell and hit his head on a brick wall...he now suffers from occipital headaches along with neck pain. he also has a 100% occulssion in the back of his neck that is in-operable thus making pt impossible for any possitive results...we were told to go home and consider a nerve blocks on both sides of his head..he has been on many medications with no great impact for relief. if anyone has any words of wisdom, please feel free to speak up..right now, we are at a loss as to what to do next...btw, just incase you're wondering, we live in central pa. Thanks!

Jack said...

hello there everyone, my name is Jack and i am about to have my first onb occipital nerve block it is scheled for 10-7-11 and i am not sure if i should do it after reading all of the comments on here. does anyone have more to say about these? a long time ago i was told i have cluster vasular migranes and they wanted to do exploreadory surgery and i said no way.

Anonymous said...

Hey everyone! I can relate to all of you as I have had headaches for almost ten years due to car accidents and a nasty ex boyfriend. I have tried all of the methods you have all suggested without success until the ONB. Had this done about a month ago and it was painful but compared to the headaches and vomiting all the time it was nothing. I was sore for a good week and got a terrible headache with vomiting and all about four days after. After that it was great to not get a headache everyday. It did not get rid of them completely but less often. Now the headaches are starting to come more often again so back to ground zero and I moved to Houston and cant find a doctor to give me anything for pain. Apparently addiction is more important than pain control. The meds were the only way I could go to work so now I guess I have to apply for disability and see dr after dr until I find one that has some ethics and compassion. Thanks for listening and any suggestions would be appreciated.

Rose Warrington said...

Hi! I just found your blog tonight while doing some research on occipital nerve blocks. I had my first set today, one one each side. I've had chronic migraines for 20+ years. They started increasing in frequency & severity about 12 years ago. No one can figure out why they suddenly got worse. I have no triggers, I'm only affected by changes in the weather. Over the years, I've seen about a dozen different neurologists, tried every migraine med there is with only temporary relief, if any. The current neuro is the only one to offer a diagnosis & possible treatment. He diagnosed it as occipital neuralgia. Then, after an MRI, he diagnosed me with Chiari Malformation & sent me to a neurosurgeon. Neurosurgeon said I don't have Chiari, so I went back to the original diagnosis of neuralgia and finally got the insurance to approve the nerve block. Like I said, I had my first set today. The procedure itself was not a big deal, took all of about 2 minutes. The numbness afterward was interesting. But as soon as that wore off, I felt as if I'd been hit by a sledgehammer in the back of my head. :-( Can't wait to see what the next few days hold, and see if this actually works. I'm hoping it does, since I've had a constant migraine now for 14 weeks.

Anonymous said...

Hey Steph,
I have been battling Occipital Neuralgia with a severe non-stop headache for 9 straight days. I had an Occipital Nerve block yesterday which is working some. I'd say I'm at 50% right now. I'm thinking of trying accupuncture and chiropractic this week and was wondering if you've had any experience with this and if so, how it has been for you.

Anonymous said...

Hi Heather, I hope you don't mind me responding. My name is Graham and i live in NSW Australia. I suffer back and neck pain combined with occipital headaches after a head on car smash 30 years ago,and tobogganing accident 7 years later.

I suffered whiplash, compression fractures, in both the neck and lumber region, due to this I suffer debilitating pain 24/7.

I suffer both occipital neuralgia & facet joint arthrosis after having C5/6 and C6/7 fusions, I also have a spinal stimulator implant in the lumbar after having L2/3 and C5/S1 fusions.

It is obvious there is some confusion over ONB & FJNB's. ONB's needles are inserted in the scalp near the ears, while FJNB's are done on the sides of the neck.

Heather I believe that from the location of your injections you had Facet Joint Nerve Blocks from
C2 to C5.

I've had both done many times (10-12) and get about 50% reduction in pain, headaches & stiffness for 6-9months.

My specialist (professor in pain management) performs both the ONB and FJNB at the same time, in a hospital with full medical staff in theatre (sterile conditions), it is carried out under sedation, using CT to guide insertion.

Surgery consists of 3/4 injections into the neck (Facet joints C2/
C5).This was followed by injections into Occipital nerves at the back of the neck near the ears.

After surgery my head, scalp and neck are numb for 2 days, pain and headaches for about 5/7 days, and improvement starts after about three weeks and last 6/9 months.

I am surprised how you guys have to suffer while the procedures take place. While results will differ for different patients, I hope this assists anyone who has the daunting task of making a decision.

You need to be as informed as possible (ask as many questions as you need, to establish what is to be done) you also must be totally confident in your decision and of your physician.

Best of luck to all.

Anonymous said...

Great info everyone... I'm having ONB injections next week and have had Facet injections several times.

ASK FOR SEDATION - especially the facet injections. It's a very painful procedure - but it works.

Anonymous said...

hi
i am supposed to have this done tomorrow
i am considering canceling
now i am really considering canceling
it sounds about as bad as i figured it would be.
thanks for telling me your real take.
i really appreciate it.
update me tomorrow, please!!!

linda said...

i have read all your blogs----did any of you have a VIDEO EEG BEFORE HAVING THE ''BLOCK'? my dr. is doing that first and has scheduled
me thenn for a the nerve block.

Anonymous said...

I am going to get this procedure done on Feb 24. I wasn't nervous until I read all these comments. It seems I can get worse from taking these shots? I dont have migraines per-say, I have a constant pressure in the back of my head that is now hurting my neck and upper back. Do you think I should get this shot? Mind you, I am having severe anxiety over the pressure in my head on its on...I'm wondering if I'm going to lose it when they give me the shots.

Lisa said...

I had my occipital nerve block 3 days ago - this is the second time. They did both sides - very quick but it did hurt...but I feel great. I have been plagued for 5 years with migraines and I am feeling more like myself than I have in years :)

Anonymous said...

Hi I got occipital nerve done today 3 needles on both side of my neck and two on the top part of my neck .sat on the bed and the Dr just did it 10 needles all together.weakness in my back and legs out of balance for about one hours back of my head frozen .no feeling .now waiting for resulte .hope it help my pain to go away , good luck to all of you

Emma T said...

Just had my first one yesterday. Little warning, signed consent form in the morning was told there was a build up of appointments due to bank holidays then was seen four hours later. No time to prepare or read up. In those four hours I was increadibly upset because I was hoping that this was a "cure", even though I'd been told so many times that I'm stuck with this and there's no "cure", just pain management. The setting was lovely, relaxed and informal with lovely nursing staff that couldn't do enough to be reassuring. I do feel sorry for the nurse who's hand I crushed during the proceedure. "you'll feel a little scratch" was not followed by "and then you'll feel a whole lot of pain and you'll hear nasty noises". As we were walking away she reassuringly said "you wouldn't get me having that done" when I'd appologised for being a big softy. But...the horrific pain I've had that seems to have been getting worse, that has had me incapacitated on strong medication in bed for the last three weeks, it's so reduced. Can not believe it. Seems to only be working on one of the two types of head pain I suffer from, so it's a case of still take the tablets, but I'll be out of bed when the kids come home tonight and I'll still be up when the little ones have gone to bed. I'll eat tea with them and it won't have to be mushy - all this for the first time in three weeks. It might only last two weeks, but that's two more weeks of relative normality with my kids that I wouldn't otherwise have. Still, I'm scared of when I have to face the pain again. Been told three times a year only.

Anonymous said...

I agree with anonymous, that this website author did not have an occipital nerve block. The nerve block normally is lidocaine or similar compound, and a steroid compound which begins to work on the pain in 3-5 days. you are right - the site and marks she shows are not the occipital nerve sites. You may want to visit a highly recommended anesthesiologist, and not just someone at a "pain clinic" who have not had a residency in anesthesia. It is technically a surgery procedure even though it only takes a few minutes to perform. To visualize the occipital nerve, the latest and best equipment for it is an ultrasound versus a fluoroscope. You may want to find someone else to help you out --- those marks -- I just had an occipital nerve block that has stopped my daily migraine, and I certainly don't have marks like that (and was not injected in that area because it is not the occipital nerve).

Heather said...

Anon (from May 21 comment) - the pain clinic where I had this procedure done is tied to a very reputable hospital system. I won't name names, but you've probably heard of them. I trust that if they told me they were doing an occipital nerve block, then that's what it was. Perhaps there are different types of them or different ways to perform the procedure. All I know is it didn't help me, but my migraines are mostly hormonal. It might help other people such as yourself and in my opinion it was worth the try.

Anonymous said...

Came across your blog after getting blocks today for the first time (went in for a routine visit and he asked if I wanted to try it and did it right then). In the past my neuro has also given me a pamphlet about what you described and at least at our hospital it is referred to as a Cervical Epidural. Hope that can clear up some of the confusion for people that might be interested. I've had a few surgeries, procedures this month and it can get confusing when different docs use different terminology.

My blocks were a combo of DepoMedrol and Bupivacaine.

Hope you find something that works for you! I am battling ON, hormonal migraines and random ones as well for over 20 years.

JamieRae' Fields said...

Heather... im only 22 and have had migraines since high school as well.. i get migraines everyday. I sound like a hypercondriact and it gets so old. I take floricet with codeine and it helps the pain but doesnt prevent it. Im so tired of taking meds. I requested the injection so i hope it helps. I also get more pain on the right side of my head. Good luck with your headaches. Best of luck to us all bc i know its horrible and tiring.
Jamie

Anonymous said...

Hi Heather.

I just had an occipital nerve block done yesterday through a pain clinic at a very reputable hospital as well. They injectedmy neck in very similar locations as your picture. I was told by the anesthesiologist that they injected the 'lower occipital nerve' as opposed to the 'greater occipital nerve'. I was told by many doctors that it was an occipital nerve block I was having done and it was the anesthesiologist that finally explained the difference!
I am hoping this will work for me as I have had 3 occipital nerve blocks done before. I also hope that people will quit telling you you did not have an occipital nerve block injection when you clearly did! :-D
Thank you for your blog. I have thoroughly enjoyed reading it. It seems we have a few health issues in common!

Heather said...

Thank YOU! I hope you find something that works. :)

Anonymous said...

good luck on it working i had it done a week ago and the pain is wprse although i didn't have to go through a that

Anonymous said...

Hi .. Iv had the worst head pain mainly located on the bottom right side of my head.. Iv tried all the meds and finally had my first occipital nerve block.. I'm on day 5 now and I'm guessing the numbness has worn off, and my pain is slowly starting to come back.. Iv got c1 c2 disc bulge and this is what the consultants tell me is causing the pain.. I was holding on to this nerve block working for me... I'm so worried that I will spend the next 10 years trial and error at getting me back to health... My life has been consumed with this pain and I hope that by some miracle it still kicks in! Good luck to everyone xx

Anonymous said...

I got my first injection today. In the doc's office not surgery suite. I was told it is to see if the occipital nerve is responsible fir my headaches. If so, the occipital breve block will help. If not, then we have ruled out one more thing it is not and can try something else. Good luck.

MARZENA ZYGORA said...

HELLO MY SUFFERING FRIENDS,,,I HAD A TALK WITH DR COOPER AT VICTORIA HOSPITAL IN LONDON ONT,,,,HE ADVICED TO DO THE ,,OCCIPITAL NERVE BLOCK AND GO ON TOPAMAX MEDICATION AS WELL,,,SO I DECIDED TO GO FOR IT,,,,,,I AM SCARED BUT I HAVE PAIN ALMOST EVERY DAY,,NO LIFE,,I AM 48,,,,ANYBODY FROM LONDON GOT IT LATELY?

Anonymous said...

i also have occipital neuralgia from blunt trauna to my head. I recently had a nerve block, so far so good. It was a very painful procedure done by a dr. i had a large lump on my head where i got the needles. its been 4 days lots of ice and motrin, i go back in 4 weeks for another block as my case is severe i just pray this comtinues to help.

c05cd50c-374a-11e2-8cad-000bcdcb2996 said...

may 24, 2012 i fell on the cement, hit my head and was passed out for a few seconds. i have had every test from my neurologist, i still have stiff neck, numbness on the right side of my face with a serve pain going up from the right side of the neck to the base of my ear, then across the right temple of the head behind my eye to the base of the top of the ear. they did say i knock the crystals from my ear. i have bad mood changes, forgetting a lot, simple things even, dizzy, can't concentrate , nausea with some vomiting (not as much as i was). they have done two nerve blocks at the base of my skull first one lasted 3 hours the other 3 weeks, neither took away all the pain just the lower pain. now i am at the pain clinic who on Oct 13th did steroid shots in the right side of the neck, it has made the head aches worse and the neck worse i hurt to been it to do dishes.. the headaches are always at least a 6 on the scale reaching 10 at long period of times. (before they were 2-6 with at times 10) they gave me pain medicines. they want to do two more series of shots than if that does not work they want to "burn the nerve endings" (which i don't know if they mean the neck or the head) my questions is what are the side effects to both these procedures?? and will i ever be normal again? to work? please help, god bless you ... i have since got one nerve block in the neck with no relief but on Nov. 13th they did three shots though the skull, having me bend over and a driver. i got the headaches at a scale about 4 or6 but still numb. till the 23rd which started to climb putting me in emergency on the 24th i passed out and the pain was so bad i felt like my bone was coming Thoth my skin. today it is a scale about 8. i go back in for more shots on the 27th.

nev said...

Has anyone ended up with an indentation after having an occipital nerve block? If so, did your head return to its original shape and the pain subside? The doctor had me sit in a chair and put my chin down. In the back of my head, he injected shots in a horizontal line from the mid point across to approximately an inch of my right ear. He then added one more shot just slightly left of the mid point, where he had begun the injections. Each shot produced a crackling sound. Within a couple hours I felt very ill. For three days I was unable to have anything touch the back of my head, and I had to sleep in a seating position. For the next several weeks, my situation worsened and my usual roller coaster of pain intensified on the right side of my face, teeth, jaw, cheek, and back of my head. The pain fluctuated, as did my mood. A few weeks after the nerve block, a large indentation appeared with lumps above and below the injection line. A photo of the back of my head without any hair was taken a few years before this procedure and it clearly shows that a change has occurred. This is only one of the excruciating issues I am dealing with. I am a female veteran who had been through major trauma in the military before this ordeal began and have now suffered for over five years due to a dental misdiagnosis and substandard care at a VA hospital. I use Morphine and Lyrica daily. Please help me if you can. Thank you for listening. May 2013 be a better year for all of us. ne.vance@yahoo.com

Anonymous said...

Hi. I just wanted to thank your for sharing. I just had nerve block injections 3/7/13 in the lower part of my head just above the neck line. I felt great afterwards so I thought, I went straight to work and my injections spots started to hurt so I rubbed it like the doctor said I could. After a few seconds of rubbing it I threw up.

Anonymous said...

Hi,I have all this information and agreed and disagreed. We have to remember that we are having different problems which require different procedures. I feel for each and every one on you. I was hit by a rogue wave in Cancun, slammed to the ocean floor and heard a snap. I had a spinal fusion at C5-6. Since then I have had every type of headache possible for the past 11 years. I still get Greater and Lessor nerve blocks and had enough Radio Frequency Ablations to kill some nerves. I finally had surgery on the greater Occipital nerves and now have 75 percent less pain. Still taking migraine meds and still get nerve blocks. Found out that I was allergic to the steroids being injected. Now use a combination of "40 year old" medication called Elavil which works on the pain receptors, and nerve blocks. Good luck to everyone and hope you can find out how to live with and treat your pain.

Rysa said...

I had two occipital nerve blocks in the back of my head two weeks ago. I'm still having the migranies. But I'm becoming dizzy alot more.

Beryl Kennedy said...

Hello. How you have all suffered. I am nearly 80 years old and after a year of left sided headache am having a GON block next week. Am dreading it - not just injection but afterwards. Thoughts and prayers welcome please. Beryl

Anonymous said...

Hello everyone! My name is Shawn and I'm 34 years old from Cincinnati. Five years ago I had a cerebral aneurysm which caused nerve damage that has resulted in constant head pain. I also suffer from what was diagnosed as cluster headaches. I had brain surgery to repair the aneurysm, but nothing has worked for the head aches. Today I received what was supposedly a greater occipital nerve block, but the MD injected the lower portion of my neck right above the shoulders. He stated I would have relief in about 4-5 hrs. After the 4-5 hrs passed I started to worry because I had no relief so, I decided to get on the internet and check if people who had the same treatment experienced relief at a later time and found this site. After reading what everyone posted and watching a video on youtube I think my MD might be a quack! Has anyone who has had the block ever had the injections so low on their neck?

Anonymous said...

Hi. I had a occipital block today. My neurologist did the injections in his office. They hurt. Like shots even with the numbing agent. But the experience was not as horrible as people have described. I don't know if this will help my headaches. My head now hurts from the injections. A couple of days will tell. But no one should undergo this or any other procedure without getting as much information as you can from your doctor.

Anonymous said...

Hi Heather,
I just had my first ONB today. After months of suffering, I was so excited at the thought that by this time tonight I could possibly be pain free. Well, I'm sorry to say, that is not the case!! I went to a pain clinic and I have to say I was very disappointed with the Dr. I'm not usually one to go to docs, and I'm REALLY not one to be fussy about things, but this was a terrible experience. I blame the doc and his bed side manner a bit but after my reseRch, not having immediate relief, I have to think that pershaps that diagnosis wasn't accurate. So, I'll continue on my path to trying to figure out what is causing this. I've been to my GP, endocrinologist, ENT, pain specialist, acupuncturist, chiropractor and even bought an incline table... No relief. I'm a 42 year old formerly active person and it's a challenge for me to get out of bed and unload my dishwasher. So frustrating! I appreciate your post and all the comments. It's always good to hear others' experiences. As I get ready to prepare a Thanksgiving feast for my family, all I can think of and be hopeful for is a relatively pain-free day so I can enjoy the holiday. My best to you all.

Wendy Motley said...

I had bilateral ONBs last Friday and yes it hurt. I had them done at a pain management clinic at a very reputable medical center at a university. The doc that performed the blocks, told me it would be uncomfortable but wow he was wrong. The left side hurt and burned but the right side is a different story. It hurt so bad that I passed out from the pain. When I came to, the doc was fanning me to help wake me up, had the blood pressure cuff on my arm and the oxygen sensor on my finger. But the numbness lasted longer than I expected and the pain level has gone from a 9 to around a 6. I have to go back on January 31st for the second round.