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Botox treatment for occipital neuralgia

A pilot study investigated the effectiveness of Botox treatment for occipital neuralgia, reporting improvements in pain and quality of life measures.

Occipital neuralgia is a chronic headache condition that commonly causes headaches originating in the occipital nerve that runs from the spinal cord up through the nerves in the scalp.

The pain from occipital neuralgia is typically treated with heat, anti-inflammatory medications, and muscle relaxant medications. 

A greater occipital nerve block is another treatment for these types of headaches.

A pilot study on the effectiveness of Botox to treat pain

An initial pilot study investigated the effectiveness of Botox to treat pain associated with occipital neuralgia.

During this study, patients received Botox injections into areas surrounding the occipital nerve and then reported their daily pain and functioning 12 weeks after treatment.

The study reported improvement specifically in sharp/shooting pain associated with occipital neuralgia, with associated improvements in quality of life measures.

A more recent study

A more recent study investigated the effectiveness of greater occipital nerve block with Botox, using ultrasound to guide the placement of the injections.

The study included 54 patients who were divided into two treatment groups.

The first group received Botox, while the second received bupivacaine; both treatments were guided by ultrasound in real-time.

Study Results

The study reported no difference in pain scores between groups at one-week post-treatment.

However, pain scores were significantly reduced in the Botox treatment group at the four, eight, and twenty-four-week follow-up periods.

No adverse effects were reported by this study, and the researchers concluded that using ultrasound to guide Botox injections was an effective method of long-term pain relief.


Taylor, M.,, (2008). Botulinum Toxin Type‐A (BOTOX®) in the Treatment of Occipital Neuralgia: A Pilot Study. Headache, 48(10):1476-81.

Ryum J.H.,, (2019). Ultrasound-guided greater occipital nerve block with botulinum toxin for patients with chronic headache in the occipital area: a randomized controlled trial. Korean J Anesthesiol, 72(5): 479-485.

Image by Jochen Pippir from Pixabay 

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