Occipital nerve block injection

This procedure, called an occipital nerve block, is where a small amount of local anaesthetic with or without a steroid is injected onto the occipital nerve. The occipital nerve runs from the neck up and over the head. This nerve can become ‘pinched’ at the base of the skull, giving rise to headaches and pain. The consultant feels that an occipital nerve block may help with your pain.

A small amount of local anaesthetic, with or without steroid, is injected. The steroid acts only around the area where it is injected and does not have the same side-effects as taking long-term steroids.

The procedure is carried out in the Chedworth Suite at Cheltenham General Hospital. An appointment will be sent to you by the pain clinic secretaries.

• You may be asked to put on a hospital gown.
• You will be asked to lie on an X-ray trolley.
• X-rays images (pictures) may be used to guide the needle.
• The area to be injected will be cleaned with antiseptic.
• The consultant will numb the area with local anaesthetic, if needed, before injecting the anaesthetic and steroid.
• You may feel some discomfort during the procedure. This is a good sign, as it helps the consultant to know that the needle is exactly where it is needed.

Although the procedure itself only takes about 15 to 20 minutes, you may be on Chedworth Suite for a couple of hours, so please come prepared for this. After the procedure, you will be offered a drink and allowed home shortly afterwards.

You may eat and drink as normal, unless your consultant advises you otherwise.

Continue to take your medication as usual on the treatment day. If you are diabetic and your blood sugar is above 15mmol/l on the day of your procedure you may not be able to have your injection, this will be decided by your consultant. If your blood sugars are above 15mmol/l leading up to your injection please contact the consultant’s secretary for advice.

For safety reasons you are asked not to drive yourself home. You should also have somebody with you for the rest of the day.

In the days following your injection you may have:

• mild discomfort around the injection site. This is expected and should settle by itself.
• an increase in your normal pain, this is usually temporary. You can take your normal pain relief to reduce any discomfort. If the pain is severe, please contact your GP for advice.
• temporary weakness and numbness in the limb or area that was treated. If it was safe to do so you may have been discharged home with these symptoms. Please take care to protect the area/limb until normal sensation returns; this will help to prevent accidental injuries.
• an allergic reaction to the injection, which results in redness and itching around the injection site. This is not serious, although we need to know about it for future treatments.
• facial redness or flushing which is a normal response to steroid injection treatment.

Your response to the injection treatment will either be assessed before you leave Chedworth Suite or you will be asked for feedback 6 weeks after the treatment.

Please provide your email address before leaving Chedworth Suite.

A member of our administrative team will email you in 6 weeks with a form to complete about the result of your injection treatment.

You will be asked to complete the form with your name, date of birth, hospital number and the name of your pain consultant.

You will also be asked to let us know how much pain relief was provided by the injection and what improvements you have noticed. The improvements may include being able to sleep better, able to do more physically, reduce medication or improvements in your mood and general wellbeing.

If you are not able to access email - Please telephone your pain consultant’s secretary 6 weeks after the injection treatment. The contact number is at the end of the leaflet. You will be asked for the same information that is requested by email.

The next step in your treatment will be decided according to your response to the injection treatment. Any further appointments will be posted to your home address.

If your pain has improved greatly, you will not need a routine follow up appointment. Instead you will be given a 6 months open appointment during which time you can contain your pain consultant’s secretary if your pain becomes difficult to manage again.

For injection treatment follow up or to rearrange an appointment please contact your consultant’s secretary, Monday to Friday between 8:00 am and 4:00 pm.

Dr Young’s secretary

Tel: 0300 422 3383

Dr Makins secretary

Tel: 0300 422 2558

Dr Harper’s secretary

Tel: 0300 422 3383

Dr Bodycombe’s secretary

Tel: 0300 422 3198

Dr Rea’s secretary

Tel: 0300 422 2804

Dr Patel’s secretary

Tel: 0300 422 2558

For all other queries please contact the:

Clinical Nurse Specialists

Tel: 0300 422 2976

An answerphone will be in operation at all times, please leave a message and we will return your call as soon as possible.

For urgent calls please contact your GP or NHS 111.

NHS 111

Tel: 111

For more information about the Gloucestershire Hospitals Pain Management Service please visit the website below:

Website www.gloshospitals.nhs.uk/our-services/services-we- offer/pain/