Occipital nerve injection

What is it?

Occipital nerve neuralgia (occipital nerve pain) is neck pain and headache that presents at the back of the head. It is usually a stabbing or pressure pain that radiates from the back of the head over the entire head.

There can be continuous pain in-between the stabs of pain. Symptoms are usually only on one side. Besides a headache, there can also be problems with vision/eye pain, ringing in the ears, dizziness and nausea. The skin where the nerve is located may feel sensitive or numb.

The occipital nerve (N. occipitalis) has two branches - a large one (major) and a small one (minor). Due to damage (neuropathy) or nerve tingling (neuralgia), symptoms can arise along the spinal cord to the nerve tips. Either one or both of the branches may be affected. The cause of the tingling can be an abnormality in the blood vessels or tingling due to muscle tension, bones or neck joints.

Treatment procedure

Preparation

Come to the hospital on the day of treatment. You do not need to be fasted for the treatment. You may eat and drink.

By law, you may not drive any vehicles or operate machinery the morning after the treatment. Therefore, make sure that somebody can take you to and from the hospital. The physician or nurses can provide you with certificates, if required. If you wish, the nurses of the Pain Centre can order a taxi for you.

Always inform the physician if:

you have diabetes or a heart condition
you are (or could be) pregnant
you are allergic to certain medication, contrast medium or iodine (disinfectant), latex, etcetera
you take blood thinners

If you have reduced kidney function, have recently experienced thrombosis or a heart attack or have had a stent implanted, you must contact your attending physician first.

Medication	Stop	Comments
Asaflow®, Aspégic® Cardioaspirin®, Aspirin® Dispirl®, Sedergin®	Stop if >500 mg/day
Marcoumar®, Sintrom® Marevan®	Seven days before the procedure	Replace with injections (see Clexane, for example) Anticoagulation before the procedure
Ticlid®	Ten days before the procedure
Plavix®, Clopidogrel Brilique®, Efient®	Seven days before the procedure
Xarelto®, Eliquis® Lixiana®, Pradaxa®	48 hours before the procedure
Fraxiparin®, Clexane® Fraxodi®	24 hours before the procedure	Restart 6 hours after the treatment 3 days afterwards, take together with regular blood thinners After a week, anticoagulation follow-up with your GP