What are Nerve Blocks for Headaches?
Nerve blocks for headaches are minimally invasive procedures used to treat various types of chronic headaches by interrupting pain signals sent through specific nerves. They are especially useful for people who do not respond well to medications or want to avoid systemic side effects.
What are Nerve Blocks?
Nerve blocks involve injecting a local anesthetic, sometimes combined with a steroid, around specific nerves in the head and neck region that are involved in headache pain. The goal is to interrupt the pain signals from those nerves to the brain.
What are the Common Types of Headaches Treated with Nerve Blocks?
Common types of headaches treated with nerve blocks include the following:
- Migraine headaches
- Cluster headaches
- Occipital neuralgia
- Tension-type headaches
- Post-traumatic headaches
- Rebound headaches
- Cervicogenic headaches (originating from the neck)
What are the Common Nerve Blocks Used for Headaches?
Common nerve blocks used for headaches include the following:
Occipital Nerve Block
- Targets greater and/or lesser occipital nerves (back of the head)
- Helps with occipital neuralgia, migraines, tension headaches
- Relief can be quick and may last days to months
Sphenopalatine Ganglion (SPG) Block
- Targets the nerve cluster behind the nose
- Helps with cluster headaches, migraines, and autonomic cephalalgias
- Can be done intranasally or with a needle
Supraorbital Nerve Block
- Targets the supraorbital nerve above the eye
- Helps with frontal migraines and trigeminal neuralgia
Auriculotemporal Nerve Block
- Targets a branch of the trigeminal nerve
- Helps with temporal migraines and facial pain
Procedure for Nerve Blocks for Headaches
During a nerve block procedure for headaches, the goal is to precisely target the nerve or nerve group responsible for transmitting pain. Before the procedure, your provider will evaluate your headache type, frequency, triggers, and treatment history. You will also sign a consent form after discussing risks and benefits. The procedure is typically performed in a clinic, pain management center, or outpatient setting and takes about 10–20 minutes in total.
During the procedure, the patient is positioned comfortably depending on the location of the targeted nerve, such as sitting upright or lying down. The skin over the injection site is cleaned with an antiseptic, and a small amount of local anesthetic may be used to numb the area. The healthcare provider then carefully injects a local anesthetic, sometimes combined with a steroid, near the nerve responsible for the headache pain—commonly the occipital nerve, supraorbital nerve, or sphenopalatine ganglion. The injection may be guided by touch, ultrasound, or imaging techniques like fluoroscopy to ensure precision.
What Happens After a Nerve Block Procedure for Headaches?
After a nerve block procedure for headaches, patients are typically monitored for a short period - about 15 to 30 minutes - to ensure there are no immediate side effects such as dizziness, numbness, or an allergic reaction. Some individuals experience immediate relief, while others may notice improvement gradually over the next few hours or days. Mild soreness or numbness at the injection site is common and usually temporary. Patients are generally advised to avoid strenuous activities for the rest of the day, but can return to normal routines within 24 hours. The duration of pain relief varies, lasting from a few days to several months, and repeat injections may be scheduled if the treatment proves effective.
Risks and Complications
Nerve block procedures for headaches are generally safe, but like any medical procedure, they carry some risks and potential complications. Common side effects include mild pain, bruising, or swelling at the injection site, as well as temporary numbness or dizziness. Some patients may experience a mild headache or lightheadedness after the procedure. Less common but more serious complications include infection at the injection site, bleeding, or an allergic reaction to the injected medications. In very rare cases, there may be nerve injury or unintended effects if the medication spreads to nearby structures.