Practice Policy Update regarding COVID-19

Occipital & Peripheral Nerve Blocks

Occipital Nerve Blocks

A greater occipital nerve block involves injecting medication around the greater occipital nerve to relieve pain. The greater occipital nerve travels through the muscles at the back of the head and into the scalp providing sensation to the back and top of the scalp.

Greater occipital nerve blocks are commonly used for patients with a unilateral headache, mainly at the back of the head. This block may also be used in patients with occipital neuralgia experiencing shooting, zapping, stinging, or burning pain in the back of the head. Patients with migraines, cluster headaches, and other painful conditions may also obtain temporary relief with this block.


During the procedure, you will lie down on an examination table. Then your doctor locates the greater occipital nerve by palpation of the scalp. The skin is cleansed with alcohol and your doctor injects a local anesthetic and steroid mix with a fine needle over the area of the trunk of the nerve. The injected region becomes numb, often relieving pain.

The anesthetic effect wears off over several hours and the steroid begins to act over the next few days. This helps provide pain relief for several days to a few months.


Risks and complications are rare but can include infection, nerve or blood vessel injury, and allergic reaction to medications. You may also feel dizzy for a short period. Sometimes, thinning of the scalp at the injection site and hair loss may also occur.

Peripheral Nerve Blocks

The peripheral nervous system carries signals of movement and senses, such as hot, cold and pain, from different parts of your body to the spinal cord and brain. Injecting an anesthetic at a peripheral nerve can block the transfer of pain signals from the region it supplies to the brain. This is called a peripheral nerve block. A celiac plexus block is a peripheral nerve injection administered at the celiac plexus, a bundle of nerves that surrounds the aorta, to block pain impulses originating from organs in the abdomen.

A celiac plexus block is indicated to relieve chronic pain in the abdominal region, most often due to pancreatic cancer or pancreatitis. It is carried out under local anesthesia and sometimes sedation. You will lie on your stomach on an X-ray table and your blood pressure, oxygen and heart activity are monitored. The region of skin to be injected is cleaned with an antiseptic solution and local anesthesia is given. X-ray images are taken to guide the needle to the correct position of the nerve plexus. A test dye is injected to ascertain the correct location. Then the anesthetic is injected gradually over a couple of minutes. Sometimes, the anesthetic is combined with a steroid to prolong pain relief, or alcohol or phenol to destroy damaged nerves. Once the medication has been injected completely, the needle is removed and a bandage is placed. The entire procedure takes about 10 to 30 minutes.

After the procedure, you may feel warmth in your abdomen, and experience pain relief that will last for a few days. For better outcome, you will be advised to have a series of 2 to 10 injections at varying intervals. The duration of relief tends to get longer after each injection.

Although it is a safe procedure, celiac nerve block may be associated with certain side effects and risks such as temporary pain and soreness at the injection site, temporary weakness or numbness near the abdominal wall or leg, bleeding, infection or injection of the anesthetic at other regions of the spine, blood vessels and surrounding tissues.