First aid is assistance given to an injured or sick person until professional medical attention is available. In order to understand whether first aid is needed for an occipital nerve block it’s useful to look at the procedure and any potential side effects.

​What Is the Occipital Nerve?

​The greater occipital nerve is a branch of the second cranial spinal nerve. The nerve exits the spinal cord between the first and second vertebrae. It then travels up through the skull alongside the lesser occipital nerve.

The nerve travels through the semispinalis muscle and continues up towards the top of the skull. The occipital nerve innervates the scalp and any injury to the nerve leads to pain in this area. Pain around the back of the head is also reported by patients with occipital nerve damage.

​What Is an Occipital Nerve Block?

​An occipital nerve block is a medical procedure used to alleviate chronic occipital neuralgia and severe headaches. Blocking the nerve stops pain signals being transmitted to the brain via the occipital nerve. The treatment is effective and pain relief can last for many months.

An occipital nerve block procedure helps patients suffering from the following:

  • ​Episodic migraine
  • ​Chronic migraine
  • ​Episodic cluster headaches
  • ​Chronic cluster headaches
  • ​Occipital neuralgia
  • ​Tension headaches

​An occipital nerve block involves anesthetics and steroids being injected around the area of the occipital nerve. The injection that delivers the medication is usually inserted behind the ear or at the back of the head.

The drugs used to inject the patient help to reduce inflammation as well as inhibiting pain signals. The procedure takes a few minutes and the patient can usually go home within a few hours. If the patient responds well to the treatment further injections can be given when the pain returns.

Having an occipital nerve block will not cure a nerve injury and it will only help to manage the pain. A physician will still need to identify the cause of the injury and treat it if possible.

An occipital nerve block is also an effective way to diagnose injuries to the nerve. When a patient has symptoms associated with occipital nerve damage an injection of medication will be given. If the symptoms ease following the nerve block it’s a good indication that the nerve is damaged.

​What Causes Occipital Neuralgia?

​A pinched nerve in the neck is one of the main causes of occipital neuralgia. Tight muscles and neck tension lead to nerve compression which damages the occipital nerve. Osteoarthritis in the upper area of the spine could compress the occipital nerve and lead to symptoms developing.

Tumors, cysts and inflammation of the blood vessels are other things that lead to occipital neuralgia. Tumors and cysts put pressure on nerves and a nerve block helps patients manage the pain until the growth is removed.

Traumatic head and neck injuries put the occipital nerve at risk of damage. Concussion and whiplash injuries sustained in car accidents are known to cause occipital nerve damage. First aid can help with the initial trauma but not the damage to the nerve.

​What Medication Is Used for an Occipital Nerve Block?

​Various types of medication is used by physicians to carry out an occipital nerve block and the drugs are different for each patient. The patient is assessed before undergoing treatment and any allergies or intolerances are taken into account. The drugs are then tailored to the patients needs.

Local Anesthetic

​Local anesthetics are used to numb areas of the body and are effective for blocking pain signals transmitted by nerves. There are different types of local anesthetic and  lidocaine is the most common one used. For some occipital nerve blocks ropivacaine and bupivacaine are used.

Local anesthetic is not permanent and the numbness will wear off over a period of time. Higher doses of an anesthetic will last longer and the patient’s age, weight and general health is taken into account when working out the dose.

Drugs affect people in different ways and there are some side effects associated with local anesthetics. Side effects include nausea, dizziness, tingling and muscle twitching. Some patients may have an allergic reaction to the drugs which may include skin rashes, itching and respiratory problems.

​Corticosteroids

​Corticosteroids are used for occipital nerve block treatments along with a local anesthetic. Steroids are an effective way to inhibit the pain signals being transmitted to the brain. Furthermore, inflammation of the occipital nerve will be reduced by using corticosteroids in the injection.

Medical studies have concluded that using corticosteroids is effective for relieving pain associated with some headaches.

Patients have experienced unpleasant side effects following an injection of corticosteroids. Side effects include increased blood sugar, high blood pressure and depression. These side effects are usually associated with high doses of IV corticosteroids.

Physicians usually recommend no more than three occipital nerve block treatments in a six month period. Having more than this increases the chances of the patient experiencing an adverse reaction to steroids. If symptoms cannot be controlled with injections the physician will look at other treatment options.

​Are There Any Side Effects Following an Occipital Nerve Block?

​Any medical procedure carries some risk and patients are advised about this before undergoing an occipital nerve block. Patients on blood thinning medication or those with heart disease should not have an occipital nerve block. Patients with uncontrolled diabetes are advised not to undergo the procedure.

Following the injection of medication to block the occipital nerve there may be a small amount of  bleeding. Applying light pressure for a few minutes will stem the bleeding and no first aid is required. If the bleeding persists the patient should bring it to the physician’s attention before leaving the clinic.

If the site of the injection is bleeding when the patient returns home then simple first aid could help. Cleaning the wound, applying some antiseptic ointment and a sterile dressing should stop the bleeding. If the bleeding does not stop professional medical advice will be needed.

There is a risk of hematoma following an occipital nerve block and this needs to be treated. Hematoma is blood pooling outside the blood vessels following trauma to the area. If the blood vessels near the occipital nerve are damaged during the nerve block procedure a hematoma could develop.

Patients may be able to treat hematoma with rest, ice, compression and elevation (RICE). In some cases hematoma will need medical attention and surgical drainage followed by medication will be needed.

There may be a small lump at the site of the injection which will should go down fairly quickly. If the lump is still there after a few days it’s advisable to consult the physician that carried out the procedure.

Localized pain at the site of the injection is normal following an occipital nerve block. The skin around the site of the injection will be sore and tender for a period of time. Taking over the counter painkillers for a few days will help to reduce any pain and soreness in the area.

If pain is still noticeable after a few days medical attention should be sought. The pain may be the result of an infection which needs to be investigated and treated if necessary.

Infection is a risk when the skin is pierced with an IV needle to deliver nerve blocking medication. If there is an infection a physician will prescribe a course of antibiotic medication. If the infection is severe the patient may need a course of IV antibiotics.

Permanent nerve damage following an occipital nerve block is a possibility which can lead to worse pain. If the nerve gets permanently damaged there is no reason to seek first aid or further nerve blocking. When the nerve is damaged beyond repair the only course of action is to manage any symptoms.

Some patients have reported worsening symptoms following an occipital nerve block. It’s not clear why this happens and more investigation is needed to see whether the treatment is suitable for some headaches. A number of patients reported no changes following the procedure.

In rare cases a complication called transient facial palsy occurs following an occipital nerve block. Transient facial palsy is a result of the local anesthetic travelling to other nerves in the are that was injected. The condition is temporary and only lasts for a few hours.

​Final Thoughts

Man in front of drawings

​Image by : ​Startup Stock Photos​​​

​If there are any problems following an occipital nerve block then first aid is not going to help. Neurology is a highly specialized field of medicine and and complications arising from the nerve block need to be dealt with by a qualified physician. Patients should report any side effects or bad reactions to the specialist that carried out their occipital nerve block.

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