64405 Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve

Name of the Procedure:

Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve

Summary

In this procedure, a healthcare provider injects an anesthetic and/or steroid medication near the greater occipital nerve, which is located at the back of the head. These injections are used to treat severe headaches and certain types of neck pain.

Purpose

The purpose of this procedure is to alleviate pain associated with headaches or migraines and some forms of neck pain. The goals are to reduce inflammation, block pain signals, and provide relief that can last for several weeks or months.

Indications

• Chronic migraines
• Occipital neuralgia
• Tension headaches
• Cervicogenic headaches

This procedure is appropriate for patients who have not responded well to other treatments such as oral medications or physical therapy.

Preparation

• Patients may be instructed to avoid eating or drinking a few hours before the procedure.
• A list of current medications should be provided to the doctor, and some medications may need to be paused temporarily.
• Diagnostic tests like MRI or CT scans may be conducted to rule out other causes of pain.

Procedure Description

1. The patient is asked to sit or lie down comfortably.
2. The area at the back of the head is cleaned and sterilized.
3. A local anesthetic may be applied to the skin to minimize discomfort.
4. Using a thin needle, the healthcare provider injects an anesthetic and/or steroid medication near the greater occipital nerve.
5. The injection takes a few minutes to administer.

• Equipment: Sterile needles, syringes, antiseptic solution.
• Anesthesia: Local anesthesia.

Duration

The entire procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or a specialized pain management center.

Personnel

• Physician (often a neurologist or pain specialist)
• Nurse or medical assistant for support

Risks and Complications

• Common: Temporary discomfort at the injection site, mild headache, dizziness.
• Rare: Infection, bleeding, nerve damage, severe allergic reaction.

Benefits

• Pain relief can be immediate or may develop within a few days.
• Relief can last for several weeks to a few months, improving the quality of life.
• Reduced need for oral pain medications.

Recovery

• Patients can usually go home shortly after the procedure.
• Post-procedure instructions may include rest and avoiding strenuous activities for 24 hours.
• Follow-up appointments may be scheduled to assess the effectiveness and plan further treatments if necessary.

Alternatives

• Oral medications (pain relievers, anti-inflammatories)
• Physical therapy
• Nerve blocks at different anatomical sites
• Alternative therapies like acupuncture

Alternatives may not provide as immediate or long-lasting relief but may be less invasive.

Patient Experience

• During the procedure: Patients might feel a brief sting or pinch from the needle. Some pressure or mild discomfort can be expected.
• After the procedure: Mild soreness at the injection site and possible temporary relief from headaches. Pain management includes over-the-counter pain relievers and ice packs if needed.