Nerve Block and Injections

Many headache patients have muscle spasms around the neck and shoulders. Injections of lidocaine often provide temporary relief, which may be needed prior to starting a program of neck-strengthening exercises and other treatments. When the muscle spasm continues to return after lidocaine injections, injections of Botox into neck and shoulder muscles may provide more long-lasting relief.

Headaches can result from “pinched” nerves around the head. This condition is particularly common in elderly headache sufferers and in the case of headaches caused by head or neck injury. The occipital nerve is one of the most commonly affected nerves. Blocking the involved nerve with lidocaine or steroids (cortisone) can be very effective in relieving this type of headache.

Sphenopalatine ganglion (SPG) block is not exactly a nerve block because instead of blocking a single or several nerve trunks, SPG block involves blocking (numbing) a collection of nerve cells. SPG is located behind the nose and right underneath the skull and its cells send nerve endings into the brain as well as to the face and head. Numbing this ganglion appears to be very effective for some patients with migraines, cluster headaches, and facial pain. The SPG block can be done painlessly with a special device which delivers the numbing medicine (bupivacaine) through a thin plastic catheter inserted through the nose. Here is more information on the SPG block.