Concierge neurology · UK
Greater occipital nerve injections for chronic headache, by a UK headache specialist.
A precise outpatient injection at the greater occipital nerve — BASH-approved for chronic migraine, cluster bridging, cervicogenic headache and occipital neuralgia. No sedation, no downtime, home immediately.
Why patients choose us
- 01
A named headache specialist, not a walk-in
A consultant neurologist or pain specialist who treats headache every week — the injection is only as good as the person doing it.
- 02
Landmark or ultrasound-guided — your call
Traditional landmark technique for speed, or ultrasound-guided at C2 for durability. We discuss which suits your headache pattern.
- 03
Sits inside a NICE NG150 pathway
A GON block on its own is a tool, not a plan. We place it inside a proper preventive strategy — Botox, CGRP mAbs, or lifestyle work as needed.
Indicative pricing
What a private greater occipital nerve injection costs in the UK.
Indicative ranges across our partner headache clinics. Send the details and we quote firm figures across two or three options.
In short
A landmark GON block in our network: £250–£350, home within the hour.
| Injection type | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Single GON block (unilateral, landmark) | £250–£350 | 20 min | Same visit |
| Bilateral GON block (landmark) | £350–£500 | 25 min | Same visit |
| Ultrasound-guided GON at C2 nerve root | £400–£650 | 30 min | Same visit |
| Multi-site frontal–occipital cocktail | £450–£700 | 30–40 min | Same visit |
| Cluster headache bridging injection (steroid) | £300–£500 | 20 min | Same visit |
| Headache specialist consultation only | £220–£380 | 30–45 min | Same visit |
Prices vary by clinic, by which specialist does the case, by whether ultrasound is used, and by whether adjacent nerves (lesser occipital, supraorbital, supratrochlear, auriculotemporal) are included. We come back with a firm quote within one working day.
The problem
The right diagnosis, the right technique, the right pathway.
A GON block done blind — without a headache diagnosis, without a preventive plan, without a follow-up — wastes an injection and a fortnight. We refuse to let that happen.
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Not sure if it is the right step?
Sometimes it is Botox first, sometimes a CGRP mAb, sometimes lifestyle work. We say what the NICE NG150 pathway actually recommends for you.
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Worried it will not work?
A diagnostic block with local anaesthetic alone gives you an answer in an hour. We do that before committing to steroid or a repeat schedule.
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Want it done properly?
A named headache specialist, the right technique for your anatomy, and a written escalation plan if the block does not deliver.
The journey
From enquiry to review — what happens, in order.
One specialist from first message to response review — including whether to repeat.
Phase 1 · Before your injection
Concierge, off-stage for you
Phase 2 · On the day
20 to 30 minutes at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what your headaches look like
A short, confidential form. Frequency, character, triggers, what has been tried, whether it is one-sided or bilateral.
- 02
Before
We come back with a recommendation
Within one working day: whether a GON block is the right next step, which technique fits, and an indicative price. If it is not the right step, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Blood-thinning medication is reviewed with the team. No fasting, no sedation — you eat and drink normally.
- 04
On the day
Arrival at the clinic
Arrival, consent, a short focused examination — the specialist palpates the greater occipital nerve and confirms the tender point.
- 05
On the day
The injection itself
Seated position, sterile skin prep, a 25G needle at the greater occipital groove. Local anaesthetic ± steroid. Immediate scalp numbness confirms the nerve is bathed.
- 06
On the day
Home immediately, drive if you wish
No sedation, no downtime. Total clinic time is 20 to 30 minutes. Some patients feel headache relief within hours; steroid effect builds over days.
- 07
After
Response review at 2 to 4 weeks
We check pain reduction, migraine days, cluster attack frequency. Repeat every 3 to 6 months if responsive; stopped after two cycles if benefit is under 30 per cent.
Typical end-to-end: 1–2 weeks from enquiry to injection. Response review: 2–4 weeks after.
When it helps
When a GON injection is the right next step.
The headache patterns we see most, plus the one red flag that means an emergency rather than an appointment.
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Chronic migraine
Fifteen or more headache days a month for at least three months, with eight or more meeting migraine criteria. GON blocks are BASH-approved.
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Cluster headache — acute bridging
A steroid-containing occipital injection can abort or attenuate a cluster bout over 1–2 weeks while verapamil is titrated up to effect.
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Cervicogenic headache
Headache arising from the upper cervical spine, meeting the Cervicogenic Headache International Study Group criteria — often exquisitely responsive.
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Post-traumatic / whiplash headache
Headache persisting after a road traffic collision or head injury, often with tender greater occipital nerve on the affected side.
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Occipital neuralgia (Arnold’s)
Sharp, shooting occipital pain with tenderness over the greater occipital nerve and a positive Tinel’s sign — a textbook indication.
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New daily persistent headache
Headache that started on a specific day and never stopped. Evidence is more variable, but a diagnostic block is often worth trying.
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Diagnostic block
A greater than 50 per cent reduction in pain after a targeted GON block supports a GON pathology diagnosis and guides further intervention.
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Red flag: thunderclap or new focal signs
Sudden severe headache, new neurological deficit, fever with headache or headache after 50 with new features is an emergency — A&E, not a clinic booking.
Injection options
One nerve, several techniques.
What each variation actually involves — and which fits which headache pattern.
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Landmark GON block
The classic technique: palpate the greater occipital groove one-third medial from the external occipital protuberance to the mastoid. Fast, effective, no imaging needed.
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Ultrasound-guided GON at C2
Ultrasound tracks the nerve deeper at the C2 root or between the obliquus capitis muscles. Increasingly used for durability and in tricky anatomy.
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Bilateral GON block
Both sides injected in the same sitting where headaches are bilateral — the default for chronic migraine, common in cervicogenic headache.
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Local anaesthetic only
Bupivacaine or lidocaine on its own — useful for a diagnostic block, or when repeated steroid dosing is a concern.
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LA plus corticosteroid
Bupivacaine with methylprednisolone 40mg/ml or triamcinolone — the standard therapeutic block for chronic migraine and cluster bridging.
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Frontal–occipital cocktail
GON combined with lesser occipital, auriculotemporal, supraorbital and supratrochlear injections for multi-site headache pain.
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Cluster bridging (steroid)
A single steroid-containing occipital injection given at the start of a cluster bout, buying time while verapamil is titrated to effect.
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Repeat maintenance blocks
Repeated every three to six months in responders. Discontinued if two consecutive cycles produce less than 30 per cent benefit.
Our vetted UK network
A small panel of headache specialists, we picked them.
Consultant neurologists and pain physicians across London and the major UK cities. Not listed publicly — introductions are made privately, once we understand your headache pattern.
Selection criteria
How we choose every specialist in our network.
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Consultant headache specialists, neurologists or pain physicians — not generalists
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Ultrasound available when C2-level or anatomically difficult injections are indicated
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The injection sits inside a NICE NG150 preventive strategy, not in isolation
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Escalation pathway to Botox (NICE TA260) or CGRP mAb (NICE TA659/682/764/1093) already in place
Safety and recovery
What to expect afterwards — honestly.
A GON injection is a low-risk outpatient procedure. The things worth planning are the scalp numbness, the steroid dose caps, and knowing what is normal after.
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Transient injection-site pain
Almost universal — a sharp sting for a few seconds, occasionally a bruised feeling for a day or two. Simple paracetamol is enough.
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Expected scalp numbness
A numb patch at the back of the head for hours to a few days confirms the nerve is bathed. This is a feature, not a side effect.
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Superficial haematoma
A small bruise at the injection site is common. Larger haematomas are rare — more likely if you take blood thinners, which is why we review these first.
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Transient dizziness or pre-syncope
A vagal response after any injection into the scalp. We keep you seated for a few minutes afterwards and check before you leave.
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Migraine flare 24 to 48 hours after
Uncommon but recognised. Usually settles within a day or two and does not predict a poor response to future blocks.
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Steroid dose caps
We limit steroid-containing blocks to three or four per year at a moderate dose to protect against Cushing’s syndrome from cumulative dosing.
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Local skin changes with repeat steroid
Repeat steroid injections at the same site can cause scalp atrophy, alopecia and hyperpigmentation. Rotation of technique and dose limits keep this rare.
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Dural puncture — vanishingly rare
Only a theoretical risk at the C2 level if the needle is placed too deep. Ultrasound guidance essentially removes it.
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Red flags
A new thunderclap headache, fever, neck stiffness, or a first-ever headache after 50 with focal signs — do not wait for a clinic. A&E the same day.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whichever technique was used, the note the specialist sends you keeps to the same shape.
A quiet reminder
Neurology language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and headache diagnosis
Why the block was done — chronic migraine, cluster bridging, occipital neuralgia, cervicogenic headache — and how the diagnosis was made.
- 02 Technique
Technique, drug and dose
Landmark or ultrasound-guided, unilateral or bilateral, which local anaesthetic and steroid at what dose, and whether adjacent nerves were included.
- 03 Findings
Immediate response and scalp anaesthesia
Confirmation that the correct sensory distribution went numb — a proxy for correct placement — and any immediate change in headache intensity.
- 04 Impression
Repeat schedule and escalation plan
Read this first: when to review response, whether to repeat at 3–6 months, and what happens if the block does not work — Botox, CGRP mAb, or reassessment.
Recognised by major UK insurers
Cover for GON injections varies by insurer and by indication — usually funded for chronic migraine, cluster headache and occipital neuralgia with a neurologist’s referral. We confirm cover before booking.
Frequently asked
Everything we get asked about greater occipital nerve injections.
Quick answers on speed of effect, cost, NHS availability, safety on blood thinners, and how often the block can be repeated.
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How quickly does a greater occipital nerve block work?
The local anaesthetic effect is immediate — scalp numbness within a minute and often pain relief the same day. The steroid effect builds over 3 to 7 days and, in responders, lasts 8 to 12 weeks. In cluster headache, a steroid-containing block can attenuate a bout within a week.
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Does the injection hurt?
A sharp sting for a few seconds as the needle goes in, then pressure as the anaesthetic is delivered. Most patients rate it 3 or 4 out of 10 for a few seconds. No sedation is needed and you drive home.
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How much does a private GON injection cost in the UK?
Roughly £250–£350 for a single unilateral landmark block, £350–£500 bilateral, and £400–£650 for ultrasound-guided C2-level work. A multi-site frontal–occipital cocktail is £450–£700. We confirm a firm figure within one working day.
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Is a GON block available on the NHS?
Yes — via specialist headache clinics, typically before escalation to Botox or CGRP monoclonal antibodies under NICE NG150. Waits are variable. The private route is used when you cannot wait, or when you want a specific technique.
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How often can the injection be repeated?
Every 3 to 6 months in responders. Steroid-containing blocks are capped at 3 or 4 a year at moderate dose. We stop after two consecutive cycles if benefit is under 30 per cent, and reroute to Botox or a CGRP mAb.
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What is the difference between landmark and ultrasound-guided technique?
Landmark technique uses surface anatomy at the greater occipital groove — fast and effective for most patients. Ultrasound-guided injection at the C2 nerve root or between the obliquus capitis muscles reaches the nerve deeper and, in some evidence, gives longer duration of effect. We choose based on your anatomy and headache pattern.
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Will a GON block stop my cluster headache?
A single steroid-containing occipital injection can abort or attenuate an active cluster bout in a significant proportion of patients, buying time while verapamil is titrated. It is a bridging tool, not a cure — and it fits inside a full cluster management plan.
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Is it safe if I take blood thinners?
Usually yes for a superficial landmark block, but the specialist reviews your specific medication and INR beforehand. Never stop anticoagulation on your own — coordinate with the team. Ultrasound-guided deeper injections have a slightly higher bleeding risk, which is factored in.