Peripheral nerve blocks have been used for the acute and preventative treatment of a variety of headache disorders for decades. These procedures provide prompt pain relief for many patients that lasts beyond the duration of the anesthesia, from several weeks or even months, possibly due an effect on central pain modulation. Greater occipital nerve blocks for migraine and cluster headaches reduce headache days and give high levels of patient-reported efficacy. Lesser occipital nerve blocks as first-line treatments in trigeminal autonomic cephalalgias may avoid the need for corticosteroids or indomethacin. Patients with headache who have reproducible pain with palpitation over the pericranial nerve area in the scalp are also likely to respond to nerve blocks. Pregnant women with headaches can often be managed throughout pregnancy and the postpartum period with anaesthetic nerve blocks, reducing the need for medications. The nerve blocks we perform at The Manhattan Center include greater occipital, lesser occipital, supratrochlear, and supraorbital injections with anaesthesia. Please call to set up a consultation to discuss if PNBs are a suitable option for your treatment.
–Alice Wong, NP