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Occipital Nerve Block For Migraine

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Who Is A Candidate

Migraine Headache Treatment: Occipital Nerve Blocks

Occipital injections work best when the typical pattern is one-sided head pain consistent with C2 nerve pain . Typically, the procedure is recommended for those who do not respond to other conservative treatments, such as anti-inflammatory medication, massage, dry needling, or physical therapy.

Occipital injections should NOT be performed on people who have an infection or have bleeding problems. The injection may slightly elevate the blood sugar levels in patients with diabetes. It may also temporarily elevate blood pressure and eye pressure for patients with glaucoma. You should discuss this with your physician.

How Long Does The Pain Relief Last

The full pain-relieving effects of the steroids can take several days to take effect.

The amount of time that an occipital nerve block reduces pain varies from person to person. However, they can cause pain relief for months in some people.

An occipital nerve block is used to reduce chronic head pain.

Some of the specific conditions its commonly used to treat include the following.

  • Migraines.Migraines are a neurological condition that usually causes intense headaches on one side of the head. People who have migraines commonly also experience nausea, dizziness, and mood changes.
  • Cluster headaches. Cluster headaches are a short but painful series of reoccurring headaches. People who experience them tend to get them seasonally.
  • Spondylosis of the cervical facet joints. Also called osteoarthritis of the joints in your neck, spondylosis of the cervical facet joints is often caused by the age-related breakdown of your neck bones and discs.
  • Occipital neuralgia. Occipital neuralgia is a headache disorder that usually causes

What Is A Supraorbital Nerve Block

Supraorbital nerves give feeling to your upper eyelids, forehead, and scalp. If damage occurs to these nerves due to infection, trauma, tumor, or constriction, you may experience supraorbital neuralgia or pain above the eyebrow that extends to the scalp.

Other symptoms include pain in the forehead and tenderness in the bone opening below your brow or supraorbital notch.

A supraorbital nerve block is a procedure that involves injecting anesthetic agents, such as lidocaine, tetracaine, and bupivacaine, into the supraorbital nerve located on each upper eye bone.

Swimmers who wear tight goggles sometimes aggravate the supraorbital nerve and cause swimmers headache. Their scalp can become painful as a result, and they may complain of painful hair.

During treatment, the nerve is accessed by injecting the skin beneath the eyelid.

In addition to treating migraines, a supraorbital nerve block helps remedy other types of pain, including pain associated with:

  • Acute herpes zoster

  • Removing foreign objects from the body

  • Recovery after surgery

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What An Occipital Nerve Block Is

During a nerve block, pain-relieving medicine is injected to the region where the nerve crosses the skull. The patient is usually lying on his or her stomach. The needle is placed near the nerve and the anesthetic are injected. Pain relief may be immediate and usually lasts as long as the numbness, sometimes the relief may be long lasting.

An occipital nerve block is done to manage:

  • Pain that affects the back of the head or one side of the head. People who have sensations of shooting, zapping, stinging or burning pain usually have the best response to the procedure.
  • Some migraines or cluster headaches
  • Spondylosis of the cervical facet joints
  • A tender or painful scalp, which may be a sign of an inflamed nerve

How An Occipital Nerve Block Is Performed

Nerve block uses, duration, nerve block procedure &  side effects

You’ll have an intravenous line put in your arm. Your doctor will set up several monitors, including heart, pulse, and pulse. Your healthcare team will monitor your vital signs. Your doctor will give you IV medicine to reduce your anxiety and give you some pain relief.

Your doctor will clean your skin where the injection will be given. A local anesthetic will be injected so that you won’t feel any pain during the procedure. The medicine for the occipital block will be inserted near your occipital nerve through a small needle near the base of your skull.

Your headache may get worse briefly when the medicine is injected. This is a sign that the medicine is going to the right place. The procedure usually lasts around 15 minutes.

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Treatments For Occipital Neuralgia

So now you may be wondering where that leaves you. Youre experiencing migraines that are officially not migraines but regular over the counter pain relievers just wont cut it. Once youre able to determine that youre suffering from occipital neuralgia you can be treated appropriately. Sometimes with some gentle stretching and the application of ice and heat packs, you may be able to temporarily relieve some of your symptoms. But if youre looking for a minimally invasive procedure

One of the most successful treatment approaches for occipital neuralgia are occipital nerve blocks. Occipital nerve block injections are a procedure where a pain-relieving solution of medication are injected to the area of your skull that contains the occipital nerves. Typically a pain management physician will administer the injection to help reduce and eliminate your symptoms. The injection will contain a long-acting anesthetic and a steroid solution, which will have an anti-inflammatory effect on the occipital nerves.

Occipital nerve blocks can also be used as a diagnostic tool as well. Let us say you and your doctor are unsure if the pain symptoms you are suffering in your head are actually from occipital neuralgia . An ONB is a safe treatment option that can demonstrate which condition you are suffering from.


Can A Nerve Block Make Migraines Worse

Because the nerve is still conducting signals, the migraine pain worsens rather than improves. This can also happen if the injection needle comes into contact with the nerve, again causing a worsening of the distressful nerve signals rather than an improvement. Now to be fair, this can happen to anyone.

Can migraine damage your brain?

Migraines cause serious pain. If you get them, youve probably wondered if they have a lasting effect on your brain. Research suggests that the answer is yes. Migraines can cause lesions, which are areas of damage to the brain.

Is there an injection for migraines?

Sumatriptan injection is used to treat the symptoms of migraine headaches .

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What Does Gon Block Involve

Your doctor will usually feel around the back of your head to locate the best place for the injection. The injection involves a fine needle. Some people find the injection stings a little bit, but generally its well tolerated and only takes a few minutes.

You will be monitored for about 15 minutes after the injection to make sure you feel ok before you go home.

The area around the injection may feel numb and tender for a few hours after the injection. Some people find the numbness spreads across the side of the head that has been injected. You will be asked to keep the injection site dry for 24 hours following the procedure.

Can A Nerve Block Help My Migraines

Occipital Nerve Block Injections 1 hour later. Headache and Migraine treatments

If youre among the millions of people in the United States who suffer from migraines, youve likely sought treatment after treatment with only mild to moderate success.

We urge you not to give up hope, as there are many ways that we can approach migraine pain. An occipital nerve block is one such avenue. While this type of block isnt for all migraine sufferers, it has brought relief to many.

At Pain Medicine Consultants, our teams goal is to offer a wide range of pain-management options, because we understand that what may work for one patient may not work for another.

Such is definitely the case with occipital nerve blocks, which we use to combat headaches and migraines. To determine whether an occipital nerve block may help relieve your migraines, read on.

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What Are Nerve Blocks

A nerve block is a pain-relieving treatment that involves injecting a local anesthetic close to a targeted nerve or group of nerves. The injection may also contain an anti-inflammatory medication to help relieve swelling that surrounds the nerves.

For migraines specifically, a nerve block that targets the greater occipital nerve in the head is sometimes used to treat chronic migraine headaches. This nerve provides sensation along the back and top of the head. It can transmit pain signals that initiate a migraine to start.

Blocking the occipital nerve with a local anesthetic can stop it from signaling pain and provide quick and long-lasting relief in many people who suffer from migraines.

How Effective Are Occipital Nerve Blocks For Migraine Relief

Occipital nerve block success rates are generally positive.

In a recent study,² 82% of participants experienced some degree of relief after an occipital nerve block, with 58% seeing significant improvement.

The participants age and number of doses were found to impact effectiveness.

61% of participants under 65 had a significant response to treatment. This is compared to 54% of patients aged 65 or older.

74% of patients who underwent two or more GON blocks had a significant response. This was compared to 36% of patients who underwent just one GON block.

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Risks And Complications Of A Supraorbital Nerve Block

A supraorbital nerve block could provide lasting relief from migraine pain. The procedure is standard, with few people reporting adverse side effects. However, it can cause some risks and complications. These include:

  • Bleeding under the skin

  • Systemic toxicity

Speak to your doctor about your condition and symptoms to decide whether this procedure is suitable for you. Your doctor will consider any other medical conditions you have to evaluate your suitability and reduce risk.

What Happens During The Nerve Block Procedure

Occipital Nerve Block

During the treatment with occipital nerve block injection for migraines, your child lies face down on a comfortable table. The area where the nerves are is numbed. A needle is inserted into the scalp and positioned to administer the medication directly into the nerve. The treatment takes approximately 15 to 30 minutes. The pain relief begins immediately. The results may last for several months. Botox® is another method for a migraine injection in the head.

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What Are The Risks

A nerve block injection is a relatively safe procedure with minimal risks. There may be some bleeding at the injection sites. The complications reported in the literature include: temporary increase in nerve pain, neuritis, neuroma, localized numbness, infection, allergic reaction to medications used during the procedure, and/or lack of pain relief.

Greater Occipital Nerve Blocks May Alleviate Photophobia Brought On By Migraines

SPAIN: According to a research study published in the Journal of Neuro-Ophthalmology, greater occipital nerve block reduces migraine-related photophobia as judged by the Utah Photophobia Symptom Impact Scale and the Korean Photophobia Questionnaire .

One of the most unpleasant symptoms experienced by migraine sufferers is photophobia. Up to 80% of migraine sufferers experience photophobia, which can occur between attacks. There aren’t many studies looking at how migraine medication affects this symptom. The majority of the proposed therapies for photophobia up to this point have been based on case reports or a small amount of research. In order to alleviate this troublesome sensation, new treatments are still required.

The researchers of this study sought to investigate how levels of photophobia associated with migraines were affected by greater occipital nerve block.

The researchers carried out a prospective observational case-control study. They sought migraine and photophobic patients who visited a headache clinic. Patients who underwent a GON block while adhering to standard clinical practice standards were considered cases. 41 patients were included in the trial, of which 28 were cases and 13 were controls. All patients were assessed during their initial visit and one week later using the Hospital Anxiety and Depression Scale, the Migraine Specific Quality of Life Questionnaire, the Utah Photophobia Symptom Impact Scale , and the Korean Photophobia Questionnaire .

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How Long Do Occipital Nerve Blocks Work

You may experience relief in as little as 15 minutes after the procedure.

The long-term results vary from person to person. Some live pain-free for months, while others only last days before getting another migraine. A second injection may be recommended in these cases however, you can only receive a limited number of doses.

What Is An Occipital Nerve Block

Occipital Nerve Block

An occipital nerve block reduces the severity and frequency of migraine headaches and pain in your neck and the back of your head.

During the procedure, a medical professional will inject a pain reliever and steroid into the greater and lesser occipital nerves.

Occipital nerves are located in the second and third vertebrae of the neck and run up on either side of the head. You may experience headaches starting at the base of the skull when these nerves are inflamed. The pain moves up the sides of your head, reaching your eyes and forehead.

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Do Occipital Nerve Blocks Cause Weight Gain

Potential side effects include but not limited to elevated glucose levels, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, or osteoporosis. Alternatives to the procedure include oral medications, physical therapy, or acupuncture.

Why Choose Wemind Institute For Pediatric Neurology Treatment

WeMind Institute works with children from birth to approximately 22 years old. Dr. Vasconcellos is a board-certified neurologist who specializes in pediatric neurology and headache medicine for families in Miami, Doral, the greater Miami area, and the surrounding communities in Florida. We also specialize in pediatric headaches and migraines, testing for ADHD, and working with children who have autism. WeMind Institute is known for offering the QbTest to diagnose ADHD, and we link parents with supplemental community programs for children with neurological disorders, including scholarships and school programs.

Dr. Elza Vasconcellos is a board-certified neurologist who specializes in pediatric neurology and headache medicine for families in Miami, Doral, the greater Miami area, and the surrounding communities in Florida. Contact us today to learn more about our pediatric nerve block treatments and schedule an appointment.

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How Long Does A Supraorbital Nerve Block Last

The ongoing effect of this treatment is not the same for everyone. While some people experience temporary relief, others are free from migraine pain for months.

A supraorbital nerve block uses different anesthetic agents. How quickly you feel relief depends on the type. Lidocaine is the fastest, with people experiencing results after approximately 75 minutes. Tetracaine takes about three hours, while bupivacaine takes the longest, at around eight hours.

A report³ detailed the caseof a 38-year-old woman who received a supraorbital nerve block. Her original symptoms included a unilateral headache, persistent pain on the left eyebrow, shooting pain with occasional numbness, and tingling on the eyebrow.

The patient reported no pain immediately after the injection was administered.

After one month of follow-up, she reported only mild pain a three out of 10 on the VAS scale.

How Long Will An Occipital Nerve Block Last

Botox and Nerve Blocks for Migraine Headaches and Occipital Neuralgia ...

There’s no way to predict how long an occipital nerve block will last. It varies for each person. Some people experience pain relief that lasts for months. For others, it’s not effective or lasts only a few days. If you experience relief but it’s short-lived, you may want to try again.

There’s a limit to how many steroid injections you should have. Your doctor will talk to you about how often you can have them.

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Occipital Nerve Blocks For Cluster Headaches

seem to be effective at treating headaches caused by cluster headaches.

In a 2013 study , researchers looked at the effect of a greater occipital nerve block on 83 people with chronic cluster headaches.

They found that participants who underwent an occipital nerve block every 3 months had significant improvements in symptoms.

More than half of the people involved in the study had significant improvements after their first treatment.

Occipital Nerve Block For Ongoing Care In The Clinic

Journal of the American Board of Family Medicine

Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M. Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study. J Am Board Fam Med. 2018 31:211-218.

Pain reduction after greater occipital nerve block was rated moderate or significant . The study suggests the effects may be cumulative, too, with 74% of patients who received two or more procedures reporting significant pain reduction compared to 36% of those who underwent only one procedure.

Unlike new options like anti-CGRP monoclonal antibodies and neuromodulation devices, occipital nerve block has been used to manage Migraine and headache pain for decades. New research supports expanding the use of nerve blocks to ER settings, where patients often go as a last resort. Study author Dr. Robbins concludes, “We certainly need more safe and effective, non-opioid therapies in the emergency department to help people with migraine.”

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Greater Occipital Nerve Injections

Infiltrations of the region of the greater occipital nerve were always performed unilaterally and consisted of 30 mg 1% lidocaine and 40 mg methylprednisolone acetate. The clinician palpated over the greater occipital nerves and injected the side that was most tender. GON injection was administered 12 cm below the midpoint between the occipital tubercle and mastoid process in all patients. The injection site was then massaged to spread the solution.

For the purpose of data collection, we included both first time and repeat injections. The primary outcome of improvement from the injection was defined as either a significant, more than one third, decrease in headache frequency or intensity or by a documented headache improvement in the clinical notes.

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