Many patients with chronic headaches, report their headaches arising from the neck or base of the skull. The pain is usually uni-lateral (one-sided). From the neck, the pain can then radiate forward towards the top of the head, forehead, eye, or all the above. This is the definition of a cervicogenic headache. These are specific headaches that arise from the neck. They can be incapacitating and resilient. Many patients with neck issues also deal with these chronic headaches. At Prairie Spine and Pain Institute, we diagnose and treat cervicogenic headaches.
Located at the base of the skull near the scalp line are the occipital nerves. These nerves can be irritated or inflamed and can cause cervicogenic headaches. The occipital nerves then transmit their pain signals to a larger network of nerves causing the debilitating radiating pain. This pain with specific patterns is known as occipital neuralgia. The character of these pains typically are numbness/tingling, nagging/dull, and lighting like shooting pains. The occipital nerves can be the ignition to the fire. Meaning if we can stop the flames from igniting, then there will be no headache or migraine. If we block the pain signals then we’ve eliminated the headaches before they’ve begun.
One technique we use to do this at Prairie Spine is occipital nerve blocks. This relatively painful and simple procedure done in the office setting has provided a solution to a chronic headache problem. Using a small needle, a solution is injected around the area of the occipital nerves. The solution typically contains a local anesthetic and sometimes a steroid. The needle-stick is generally painless but sometimes the injected solution does cause some very brief discomfort lasting only seconds. The onset of the block can begin immediately and last for several months.
This procedure is very safe and has very few minor complications. Occipital nerves are sensory nerves and because we inject local anesthetic close to them, there can be some temporary numbness felt over the regions supplies by these nerves. Also minor bleeding and hematomas have been reported. The procedure takes about 1-2 minutes and is performed in a regular exam room. Patients can return home or to work with absolutely no restrictions. Patients who do have significant relief but the headaches return, sometimes benefit from a second injection.
Occipital nerve blocks are not for every patient who has headaches. However, for many patients, they have eliminated a previous chronic debilitating condition. There is marked improvement in symptoms, decreased number of headaches, and major improvement in everyday function. If you have headaches that arise from your neck, come see us Prairie Spine and Pain Institute.
About The Author: Derek N. Morrow, PA-C is a physician assistant with Prairie Spine and Pain Institute. Derek works in the clinic setting as a health care provider seeing patients. He is also utilized in the operating room as a first assist in surgery. In the clinic setting, his key function is to diagnose new patients and conduct their initial treatment. He works directly with patients to establish customized treatment programs and to monitor their progress. He also conducts history and physical evaluations for many patients. He performs many office procedures including trigger point injections, large joint injections, and bursa injections, all with the help of ultrasound guidance. He is radiologically trained, and uses his knowledge of X-ray, Ultrasound, MRI, CT, and EMG-Nerve Conduction Studies to establish a diagnosis and determine the appropriate treatment. Derek is surgically trained and plays a vital role in the procedures we perform at Prairie Spine and Pain Institute.