I've had both, facet injections and direct blocks, and now the direct occipital block is a necessity when I get the facet blocks. The repeated steroid injections have helped to calm the ON down, but it's returning and they can only do three with steroids, so the last one will get done when the doctor does the rhizotomy. He is hoping that it will free up the muscles which are aggravating the occipital nerve as both the greater and lesser occipital nerves pass through the muscles of the neck and the vertebra. And if it doesn't, he's willing to burn the occipital nerve, but I haven't made my mind up about that one yet.