Nerve Block for Migraine: What You Should Know

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People who suffer from migraines and can't find relief from over-the-counter (OTC) pain relievers or other methods may have another alternative: nerve blocks. A nerve block involves getting an injection of a local anesthetic close to a nerve to decrease pain.

Nerve blocks are a common treatment option for pain in many body parts, including the legs, arms, buttocks, back, neck, and face. Fortunately, nerve block treatments can also help relieve migraine pain.

This article provides an overview of nerve blocks for migraines, as well as the benefits and side effects of treatment.

Women with headache

Peter Dazeley / Getty Images

What Are Nerve Blocks?

A nerve block is a pain-relieving treatment that involves injecting a local anesthetic close to a targeted nerve or group of nerves. The injection may also contain an anti-inflammatory medication to help relieve swelling that surrounds the nerves.

For migraines specifically, a nerve block that targets the greater occipital nerve in the head is sometimes used to treat chronic migraine headaches. This nerve provides sensation along the back and top of the head. It can transmit pain signals that initiate a migraine to start.

Blocking the occipital nerve with a local anesthetic can stop it from signaling pain and provide quick and long-lasting relief in many people who suffer from migraines.

Effectiveness

Research shows that greater occipital nerve blocks may be an effective pain-relieving treatment for some acute migraine headaches.

One study analyzed patients who had at least one greater occipital nerve block and at least one follow-up appointment. Patients answered questions about whether their pain reduction was minimal, moderate, or significant at the follow-up appointment.

Around 82% of patients said they had moderate or significant pain relief from the occipital nerve block. In the review, researchers also found that the nerve block was equally effective for all ages and sexes.

However, another small study found that greater occipital nerve block was not a very effective treatment for acute migraines, with only about one-third getting relief from the injection.

Although much less common, sometimes a patient may not find pain relief with an occipital nerve block or might even have increased pain following the procedure.

Procedure

The following are the typical steps of a nerve block procedure:

  1. Patients may be seated or may lie face down for easy visualization of the back of the head and neck.
  2. The skin on the back of the head is numbed with a topical anesthetic.
  3. Using a small needle, the treatment provider injects local anesthetic with or without steroids into the back of the head, right above the neck, and close to the greater occipital nerve. They may communicate during the procedure to ask what you are feeling regarding numbness on the head.

The procedure takes only a few minutes to complete.

Many patients can feel their scalp numb from the anesthetic during the procedure and feel pain relief quickly, sometimes within minutes. For swollen nerves, steroids can help relieve pain associated with swelling.

It can take a few days to see full results in some cases. Pain relief can last for weeks or months.

Post-Procedure Care

Because there is no general anesthesia involved, patients are awake throughout the procedure. However, it is still a good idea to arrange for someone else to drive you home. Most people are able to resume normal activities the following day.

Side Effects

Side effects are usually temporary and resolve in about six to eight hours. The side effects can include:

  • Infection
  • Pain, bleeding, or oozing at the injection site
  • Weakness
  • Numbness
  • Light-headedness
  • Temporary numbness over the areas treated with topical anesthetic

If the local anesthetic leaks into spaces close to the lower brain stem and upper spinal cord, it is possible—though uncommon—to experience short-term difficulty talking or swallowing. However, this side effect would reverse once the local anesthetic injection wore off within a few hours.

Contact your healthcare provider if you are experiencing side effects from the nerve block.

Summary

Greater occipital nerve blocks can treat migraine headaches, especially for those who can't find relief with over-the-counter pain relievers. The procedure involves injecting a local anesthetic close to the greater occipital nerve. The injection may also include an anti-inflammatory medication to help calm down swelling that surrounds the nerves.

Nerve blocks, while not for everyone, have proven to be effective at providing moderate to significant pain relief for some migraine sufferers. Side effects can include infection, pain or bleeding at the injection site, weakness, numbness, and lightheadedness.

A Word From Verywell

Migraines can be excruciatingly painful, frustrating, and even debilitating in some cases. When other treatment options are not providing relief, you may wish to discuss nerve blocks with your healthcare provider to see if they might help you.

Finding an effective treatment plan is essential to living with migraine pain. In many cases, that may require a combination of treatments, maintaining a healthy lifestyle, and following your healthcare provider's migraine preventive care recommendations.

Frequently Asked Questions

  • How long does a nerve block last?

    Occipital nerve blocks can take up to a few days to see results. From there, the pain relief can last for weeks or months following the injection.

  • How long does it take for a nerve block to work?

    The time it takes for a nerve block to work depends on the part of the body having pain, the affected nerve, and the patient. Sometimes it can take only a few minutes, but in some cases, full results take up to a few days.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G. Greater occipital nerve block in migraine prophylaxis: narrative review. Cephalalgia. 2019;39(7):908-920. doi:10.1177/0333102418821669

  2. Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M. Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study. J Am Board Fam Med. 2018;31(2):211-218. doi:10.3122/jabfm.2018.02.170188

  3. Friedman BW, Mohamed S, Robbins MS, et al. A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide. Headache. 2018;58(9):1427-1434. doi:10.1111/head.13395

  4. Migraine Surgery Specialty Center. Why did the nerve block from my neurologist make things worse?.

  5. Cedars Sinai. Occipital block.

  6. University of California. Occipital nerve block.

  7. American Migraine Foundation. Occipital nerve blocks.

By Sarah Jividen, RN
Sarah Jividen, RN, BSN, is a freelance healthcare journalist and content marketing writer at Health Writing Solutions, LLC. She has over a decade of direct patient care experience working as a registered nurse specializing in neurotrauma, stroke, and the emergency room.