What is a Greater Occipital Nerve Injection?

A greater occipital nerve injection is a procedure used to help diagnose and treat pain in the back of the head and upper neck. The greater occipital nerve supplies sensation to this area. Irritation or inflammation of this nerve can contribute to headaches or occipital neuralgia.

The injection contains a local anaesthetic (numbing) and sometimes a small amount of steroid (anti-inflammatory).

In some cases, your doctor may also use pulsed radiofrequency treatment to help reduce nerve-related pain. This technique applies a controlled electrical field to the nerve without destroying it.

Why is it done?

This procedure may help:

  • Reduce pain in the back of the head and neck.
  • Diagnose whether your pain is coming from this nerve.
  • Reduce headaches (including some types of migraines and cluster headaches).
  • In selected cases, pulsed radiofrequency can provide longer-lasting relief.

How is the procedure performed?

You will be lying face down on an examination table.

  • The skin over the injection site (just below the base of the skull) is cleaned with antiseptic.
  • The doctor uses ultrasound guidance to accurately locate the nerve.
  • A small needle is inserted near the nerve.
  • Local anaesthetic (and possibly steroid) is injected.
  • If pulsed radiofrequency is used, a special electrode delivers mild electrical stimulation for several minutes.
  • The procedure takes about 15–20 minutes.

What should I expect afterwards?

  • You may feel numbness or tingling in the back of the head for a few hours.
  • Some immediate pain relief is common.
  • Longer-lasting benefit (from steroid or pulsed radiofrequency) may take up to a couple of weeks to develop.

Are there any risks or side effects?

Complications are uncommon. Potential risks include:

  • Mild tenderness or bruising at the injection site.
  • Temporary dizziness or lightheadedness.
  • Infection (rare).
  • Bleeding (rare).
  • Allergic reaction to the medication (very rare).
  • Temporary increase in pain before improvement.
  • If pulsed radiofrequency is used, you may experience mild tingling or warmth during treatment.

How should I prepare?

  • You can usually eat and drink as normal unless instructed otherwise.
  • You must arrange someone to drive you home after the procedure
  • Tell your doctor if you:
    • Have any allergies.
    • Take blood thinners.
    • Have an active infection or illness.

Aftercare

  • You can generally return to normal activities the same day.
  • Avoid strenuous activity for 24 hours.
  • Keep the injection site clean and dry.
  • If you develop severe headache, fever, or significant swelling/redness, contact your doctor immediately.

When will I know if it worked?

  • If the pain improves immediately, it suggests the nerve is involved in your symptoms.
  • Effects of steroid or pulsed radiofrequency may take up to a couple of weeks to develop.
  • Pain relief can last from several weeks to a few months in some cases.

Questions?

If you have any questions or concerns, please speak to your treating clinicia

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