Head & Neck Nerve Blocks

I am 46 years old and I have been suffering with migraines for over 20 years and recently they have become much more often and more severe. I have tried every type of medicine, presribed and over the counter, vitamins, supplements, chiro, massage, physical therapy, accupuncture, infusion therapy, etc. My neurologist doesn't even know what else to do. He is recommending nerve blocks. Has anyone tried head & neck nerve blocks for migraine relief? TY

I had the nerve blocks done all over my head. I think I had them done 3 times. they only lasted a few days and my neuro said it wasn't worth it.

But everyone is different. If I were you I would definatly give it a try. You never know!

Wish you the best.
Sherri B!

I really haven't heard of too many people helped by them (any?). Tried it and didn't feel any different. Also tried trigger point injections. The occipital nerve blocks are very helpful however if you have occipital neuralgia though (many times a neuro will have a patient with migraine try the occipital nerve block to potentially diagnose and treat occipital neuralgia, especially if they have the neck pain). Worth a shot if you can afford them. If I had to choose (assuming same cost), I'd try Botox over a nerve block (still haven't tried it as its not covered by any insurance I've had). Although, with nerve blocks, if the first one tries you don't need to try again, and with Botox, I've heard to try up to 3 times before giving up, as it builds up or something, so there is even more cost with that... I'll try anything once which I can financially manage that has reasonable chance of helping and low risk (which so far has been everything but Botox and surgery)...Botox more so because I'm afraid it will help and there I am paying thousands of dollars a year to keep up with it. Best wishes.

I personally wouldn't waste my money on Botox, all it did to me was give me such a bad stiff neck that I couldn't even turn my head... seriously it was bad, but them again, I have seen on here where it has helped some people, so everybody is different.

Hi Jewerta,

I had an occipital nerve block a couple of years ago. It was a total waste of money. I had more success with botox. The success of botox very much depends on the injection site and the skill of the surgeon. It will probably take a few trials and errors before you will be able to tell if this works for you. Then again if the botox doesn't do anything for your headaches and least you will look pretty and wrinkle-free. A small consolation ... but still ....

Love

P.

PS: Nice new picture Sherri!

Ah the irony. I too am having no relief from medication, so my neuro started me on full occipital nerve blocks. It's hard to find doctors to give you more than a mild nerve block, but the clinics I went to gave me enough to last two months. It was wonderful. No migraines, no symptoms, nothing until the block wore off. Unfortunatley they've stopped working now after nearly a year. People are telling me you can only have them done so often in a year, some people say having them done at all is dangerous. I don't know. I just know I'm very upset because I don't know what I'm going to do now. Still, if your neurologist is willing to try them and your insurance is willing to pay I say there's no harm in trying. Hopefully they might give you some relief.

yes same as starburst. its been wonderful for me to have the blocks!

I was just about to come on here and post a similar thread.

I have had a horrific run of headaches over the last 2 months that seem to emanate from my neck. Nothing will even make a dent in them. Not narcotics, and not my migraine meds (Frova. Maxalt). The headaches are as painful behind one eye as they are on the same side on the back of my neck. A double whammy. I get really bad eye fatigue when they happen as well. They are horrible, and i have been in Emerg twice in the last 4 weeks to get something to abort them.

I am in a situation where I have to research either the Botox or the nerve blocks myself.

I've had both nerve blocks and botox (once). The nerve blocks only seem to last a few days on me. The botox didn't seem to help too much other than on my forehead (my temples are where the worse pain is and it didn't help there too much). Botox has been FDA approved now though so I don't have to worry about my insurance since they have to cover it if you fall within the guidelines of having more than 15 migraines a month.

I had a series of three sets of cortisone shots in my neck. All I got for my trouble is a painfully stiff neck and headache for three days.

The sedation buzz was fun though...

Dawn,

where did you get the injections (occipital nerve?) and what did your doctor inject?

P.

yes petzi he injects both sides of the head at the occipital nerve and he injects a premixed solution of a steroid and local aneastheic. it lasts about 8-10 weeks.

Dawn,

That's what I think I got injected too. I am not sure about the steroids, but I definitely had an anesthetic injected. I felt the anesthetic numbing the back of my head for abut 3 days. After that the effect was gone.

Did you feel the numbness from the anesthetic for 8 - 10 weeks? How can this possibly affect pain at the front of the head (i.e. forehead and temples).

Would it not make more sense to get a nerve block into the trigeminal nerve numbing the forehead and temples?

I have got to talk to my neuro about this again when I see him on the 18th.

Love

P.

I have had nerve blocks and they really didn't do anything for me at all. I do get botox and it has helped. It is not a cure though, it just turns the pain down to a manageable level for me.

Hi, I am not sure what the ''nerve blocks'' are that everyone seems to be having in the US. As i read it, its a local anesthetic with cortisone?

I have had a "nerve ablation" into the facet joint in my neck. It is done under local anesthetic and they use a CT scan to make sure the needle is in the correct position, then a wire is passed through the needle and the nerve is burnt. The nerve can repair itself after a long time so you may need to have the procedure done more than once.

I went in with a 7 headache and it was totally gone after the procedure - and it worked for about 8 months, I have since has another. It is a bit of a scary procedure but the Doctor was amazing and there was very little discomfort.

Can't comment on the other botox injections and so forth as I have never given them a go. They are very expensive in Australia as they come under the cosmetic industry so no insurance will pay for them.

Annabella,

That sounds like something to look into. I've not heard of anything like that here. I am going to ask my neuro about it.

Glad it's working for you, and 8 months is great.

Thanks
Sherri B!

Well I had a thing similar to the newve ablation done. It was with an Anesthesiologist. He inserted a cathereter in to a nerve in my face, then pushed a thin wire through that. He then basically electrocuted the nerve. It took 2 minutes to electrocute each spot. We were planning on doing 6 points, originally, but I managed through 18. This was painful. I was unable to have any sort of sedation or pain medication during the procedure. If it worked they wanted to know right away to know which area to target. Unfortunately it didn't work. One side effect I have had is flushing in that side of my face and neck. It has been several years, and it isn't as bad now. After the procedure I insisted that they dope me to the gills, as I had a 2+ hour drive home!! It wore off half way and I was just really sore.

hi sherri

sending you a link to nerve ablation of the type i had - they used the one needle with me and just repositioned it - dont watch it if you are squeamish though :-)

https://www.youtube.com/watch?v=NY-nbJ_aOr0&NR=1

annabella

Annabella, was this abalation injected into the vertebrae of your spine? If so, do you know which vertebrae? I'm not sure what this is, but it sounds slightly similar to what I'm having done next week. A neck specialist will be injecting a steroid into the C4-C5 of my certival vertibrae. He says it's likely to reduce my pain signifcantly since this vertibrae (where I have a bulging disc) is responsible for jaw/facial/head/pain. All of my symptoms seem to align with this theory as a source of my pain. Just curious if your procedure was similar. Thanks!

Greent

I have had the procedure where they inject cortisone into the neck like you are describing. The first time I had it done it worked great as I had a bulging disk. They use a local anesthetic so you don't feel any pain with the injection, just a lot of pressure. They do the injection with some sort of scanning machine so that they can see exactly where to place the needle. You cant see it as you are face down the whole time. (All I ever saw was my doctor's shoes).

Then you go home and sleep for a bit as the anesthetic wears off. I went from 9-10 on the pain scale, to pretty much no neck pain after the first injection. The numbness in my fingers (due to the nerve being pinched by the bulge) also went away.

Unfortunately I ended up with the chronic daily headaches after that. Additional injections into the vertebrae and the facets did not do any good as the problem was no longer due to swelling or bulging disks causing the problem. It took several years for me get a proper diagnosis of chronic daily migraine. For a long time I thought the headaches were due to this neck problem. Only recently has it become clear that the neck pain was really part if the migraine syndrome.

So, if you have a bulging disk, I think the procedure is likely to help. If it is just due to migraine then perhaps not. But it is definitely worth a try to find out!

Hi Greent

The specialist knew where the spot was that needed ablating as i had a ct scan beforehand, which showed narrowing of the disc space in the facet joint which holds the nerve ''bundle'' (3rd occipital nerve, branch block) responsible for my daily right sided headaches. It was a real reprieve for me and I can manage the occasional headache effectively now with just aspirin instead of the more potent, addictive drugs.

I have heard that after the 2nd or 3rd block, many people have permanent relief. I have had 2 and the specialist rooms call occasionally to ask my daily headache and pain level. They look after me very well.

I have also had an injection of cortisone and local anesthetic into a facet joint in my lower back and that has lasted me for about 7 months so far. This is a different procedure, though it is also done under ct scan as well. I was getting severe sciatica with a trapped nerve. I no longer have to take medication for nerve pain which is terrific.

Both the procedures were performed with local anesthetic, I could not imagine the pain that it would cause if it was not used. I was nearly sick when i read that a poster had all those injections into their face without local. Arrgh!!

I get severe migraines daily & I've had migraines for 38 years. I was in a bad car accident in 2000 and that is what has made them worse. I am seeing a pain specialist who is an anesthesiologist. I've had head blocks before for Occipital migraines, but I found out that when you take pain meds they don't work as well. I don't take any pain meds any more and he is going to try a Sphenopalatine Block. He said it works on 75% of his patients. He does them through the nose. I know there are other ways of doing them, but this is the way he is going to do it for me. I'm nervous, but very excited to have it done. I can't stand this pain.

Welcome! I had to look up this type of block as I haven't heard of it. Sorry, but I highly doubt your doctor has had 75% success with this. If so, more doctors would be using it. No known headache treatment has anywhere close to that type of percent success as each patient is so different. Maybe he had 75% get some type of relief (including very little or very short lived), out of a very specific group of patients?

How long is the relief supposed to last? Although more folks get relief from the anesthetic part (that lasts hours or days), its a select few who respond to the steroid part of nerve blocks (that can last months). What type of headache is this block supposed to treat? Looks like it is more in the face/cheek area.

I'm curious that this doctor says blocks wouldn't work while on pain meds, as my pain specialist definitely doesn't believe this. I guess you're always taking a risk they are messing with your nerves, but I'd think you'd feel something if it was to help. Hope it helps you! I think pain specialists are a good route, especially when neuros haven't been helpful, although a lot of the treatment ideas do overlap. I've had occipital, supraorbital, and temporal blocks. Best wishes.

Here is some information on the procedure done by dentists through the nasal passages:

http://www.northmiamibeachdentist.com/headaches.php

From what I read, on other websites, MDs enter from the side of the face, using a scan to make sure they hit the right spot.

Some say the success rate is 60%, others 80%.

Martin

Please let us know how well it works out for you.