What is this procedure?
Local anesthetic, sometimes with a corticosteroid, is placed near an occipital nerve at the back of the head.
When might it be considered?
Selected headache disorders or occipital neuralgia after a clinical evaluation. Your physician will determine whether this approach is appropriate and discuss alternatives, including non-procedural care.
What to expect
The clinician identifies the nerve region and administers medication; local scalp numbness may follow. Your clinician reviews your history, medications, allergies, and any relevant tests. The team explains the procedure and obtains your consent. Positioning, skin preparation, local numbing, and imaging guidance may be part of the visit, depending on the procedure.
Tell your care team about pregnancy, infection, medication allergies, or blood-thinning medicines. Do not stop or change medicines without instructions from the clinician managing them.
Potential benefits
Temporary relief may help with diagnosis and symptom management. Benefit varies between people. Benefit and duration vary; some patients experience little or no improvement. An injection is one possible part of a broader care plan.
Possible risks & side effects
Soreness, dizziness, bleeding, infection or nerve injury are possible. Steroids can occasionally cause local skin thinning or hair loss.
This is not a complete list of risks. Your physician should explain the options, limitations, and consent information specific to your planned procedure.
Recovery & follow-up
Follow activity guidance and keep track of headache frequency, severity and duration of relief. Observation and activity instructions depend on the procedure, medication, and your response. Ask whether you need a driver and when you can return to usual activities. Follow your own discharge instructions rather than a general online timeline.
Contact your care team about unexpected or worsening symptoms. Seek urgent medical help for severe symptoms, difficulty breathing, or new significant weakness.
Common questions
Does this help every migraine or headache?
No. The diagnosis and headache pattern matter, and the response is not guaranteed.
Will this procedure relieve my pain?
It may help selected patients, but improvement is not guaranteed. Your physician will discuss realistic goals based on the suspected source of your pain.
Will I need more than one injection?
The need for further treatment depends on your response, the diagnosis, and safety considerations. There is no automatic course of injections that suits everyone.
How should I prepare?
Ask the team for your specific instructions, including medicines, food and drink, transportation, and what to bring. Do not change your medicines based on this page.
Is this available at Columbia Pain Management?
Contact the office to discuss eligibility and scheduling. Your physician will assess whether a procedure is appropriate for you.
Patient education reference: my.clevelandclinic.org — patient education.