The Use of Occipital Nerve Blocks & Trigger Point Injections in Headaches with Occipital Tenderness

Abstract

Introduction: Occipital nerve blocks and trigger point injections are often used to treat headaches of

various etiologies. The extent and duration of benefit from these injections reported in the literature

varies widely. In one community neurology clinic, patients who receive these therapies often report

reduced pain and improved quality of life lasting two to three months after treatment.

Methods: A retrospective chart review of patients who received occipital nerve blocks in a single neurologists office during the dates of January to July 2014 was performed.

Results: Seventy-one patients were treated in the study. Eighteen were treated with occipital nerve blocks alone while fifty-three received nerve blocks and trigger point injections. Overall, both groups had a median length of benefit of 8 weeks and 91% of patients received benefit. The group who received occipital nerve blocks with trigger points injections had an average increase in benefit of less than one week compared to nerve block only.

Conclusions: The effectiveness and low side effect profile of occipital nerve blocks make it a useful therapy in patients with difficult to control headaches. In this study, the addition of trigger point injections did not lead to a significant increase in length of benefit over occipital nerve blocks alone. The inclusion criteria of occipital tenderness may be responsible for the higher response rate of these nerve blocks compared to prior studies.