Table of ContentsView AllTable of ContentsHow a Nerve Block WorksTypesEffectivenessSide Effects
Table of ContentsView All
View All
Table of Contents
How a Nerve Block Works
Types
Effectiveness
Side Effects
A nerve block for migraine headaches involves an injection of a local anesthetic into the base of the skull or around the forehead near a nerve. It may decrease pain frommigraineswhenover-the-counter (OTC) pain relieversor other treatments have not provided relief.
Nerve blocksare a common outpatient medical treatment for pain in many body parts, including the legs, arms, buttocks, back, neck, and face.
The injections can be effective for headaches, but there are side effects to be aware of.
Peter Dazeley / Getty Images
How a Nerve Block for Migraines Work
A nerve block is a pain-relieving treatment that involves injecting alocal anestheticsuch as lidocaine close to a targeted nerve or group of nerves. The injection may also contain corticosteroid or other anti-inflammatory medication to help relieve swelling that surrounds the nerves.
During the procedure, the skin on the back of the head or near the forehead is numbed with a topical anesthetic. Your healthcare provider then inserts a small needle with the anesthetic into the area to inject the medication near the targeted nerve.
The procedure takes only a few minutes to complete.
The local anesthetics may cause numbness for a few hours, but should not cause any noticeable problems.
How Long Does a Migraine Nerve Block Lasts?It can take a few days for the full effects of the nerve block to be realized. Relief from migraine pain can last for several days to months.
How Long Does a Migraine Nerve Block Lasts?
It can take a few days for the full effects of the nerve block to be realized. Relief from migraine pain can last for several days to months.
A nerve block can be repeated every two to four weeks. If you receive injections with a corticosteroid, treatments are administered about every three months.
To treat migraine headaches, your healthcare provider can target one of two nerves:
How Effective Is a Nerve Block for Migraines?
Depending on the type of migraine and the reasons you may have developed headaches, your healthcare provider may recommend a nerve block administered just to the occipital nerve or just to the supraorbital nerve or an injection into both areas.
Research has shown that treatment of the occipital nerve alone or a combined treatment of both areas may be more effective than a supraorbital nerve block alone.
There is a greater body of evidence supporting an occipital nerve block compared with combined treatments or injections just to the supraorbital nerve.
Studies on the effectiveness of an occipital nerve block for migraines have found the following:
Nerve Block vs. Botox for Migraines
Both treatments can be effective. Which one is best depends on your symptoms and your healthcare provider’s assessment.
Side effects are usually temporary and resolve in about six to eight hours.
Possible side effects of a nerve block injection include:
Post-Procedure CareBecause there is no general anesthesia involved, patients are awake throughout the procedure. However, it is still a good idea to arrange for someone else to drive you home. Most people are able to resume normal activities the following day.
Post-Procedure Care
Because there is no general anesthesia involved, patients are awake throughout the procedure. However, it is still a good idea to arrange for someone else to drive you home. Most people are able to resume normal activities the following day.
Summary
A greater occipital nerve block and supraorbital nerve block can treat migraine headaches, especially for those who can’t find relief with over-the-counter pain relievers. The procedure involves injecting a local anesthetic close to the targeted nerve. The injection may also include an anti-inflammatory medication to help calm down swelling that surrounds the nerves.
Nerve blocks, while not for everyone, have proven to be effective at providing moderate to significant pain relief for some migraine sufferers. Side effects can include infection, pain or bleeding at the injection site, weakness, numbness, and lightheadedness.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G.Greater occipital nerve block in migraine prophylaxis: narrative review.Cephalalgia. 2019;39(7):908-920. doi:10.1177/0333102418821669Association of Migraine Disorders.Chapter 5, Episode 4: Nerve Blocks for Migraine Disease.Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M.Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study.J Am Board Fam Med. 2018;31(2):211-218. doi:10.3122/jabfm.2018.02.170188Haładaj R, Polguj M, Topol M.Anatomical variations of the supraorbital and supratrochlear nerves: Their intraorbital course and relation to the supraorbital margin.Med Sci Monit. 2019;25:5201-5210. doi:10.12659/MSM.915447Özer D, Bölük C, Türk Börü Ü, Altun D, Taşdemir M, Köseoğlu Toksoy C.Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study.Curr Med Res Opin. 2019;35(5):909-915. doi:10.1080/03007995.2018.1532403Effective Health Care Program, Agency for Healthcare Research and Quality.Systematic Review: Acute Treatments for Episodic Migraine.Friedman BW, Mohamed S, Robbins MS, et al.A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide.Headache. 2018;58(9):1427-1434. doi:10.1111/head.13395Migraine Surgery Specialty Center.Why did the nerve block from my neurologist make things worse?.Johns Hopkins.Botulinum Toxin Injectables for Migraines.Chowdhury D, Datta D, Mundra A.Role of Greater Occipital Nerve Block in Headache Disorders: A Narrative Review.Neurol India. 2021;69(Supplement):S228-S256. doi:10.4103/0028-3886.315993
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G.Greater occipital nerve block in migraine prophylaxis: narrative review.Cephalalgia. 2019;39(7):908-920. doi:10.1177/0333102418821669Association of Migraine Disorders.Chapter 5, Episode 4: Nerve Blocks for Migraine Disease.Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M.Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study.J Am Board Fam Med. 2018;31(2):211-218. doi:10.3122/jabfm.2018.02.170188Haładaj R, Polguj M, Topol M.Anatomical variations of the supraorbital and supratrochlear nerves: Their intraorbital course and relation to the supraorbital margin.Med Sci Monit. 2019;25:5201-5210. doi:10.12659/MSM.915447Özer D, Bölük C, Türk Börü Ü, Altun D, Taşdemir M, Köseoğlu Toksoy C.Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study.Curr Med Res Opin. 2019;35(5):909-915. doi:10.1080/03007995.2018.1532403Effective Health Care Program, Agency for Healthcare Research and Quality.Systematic Review: Acute Treatments for Episodic Migraine.Friedman BW, Mohamed S, Robbins MS, et al.A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide.Headache. 2018;58(9):1427-1434. doi:10.1111/head.13395Migraine Surgery Specialty Center.Why did the nerve block from my neurologist make things worse?.Johns Hopkins.Botulinum Toxin Injectables for Migraines.Chowdhury D, Datta D, Mundra A.Role of Greater Occipital Nerve Block in Headache Disorders: A Narrative Review.Neurol India. 2021;69(Supplement):S228-S256. doi:10.4103/0028-3886.315993
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G.Greater occipital nerve block in migraine prophylaxis: narrative review.Cephalalgia. 2019;39(7):908-920. doi:10.1177/0333102418821669Association of Migraine Disorders.Chapter 5, Episode 4: Nerve Blocks for Migraine Disease.Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M.Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study.J Am Board Fam Med. 2018;31(2):211-218. doi:10.3122/jabfm.2018.02.170188Haładaj R, Polguj M, Topol M.Anatomical variations of the supraorbital and supratrochlear nerves: Their intraorbital course and relation to the supraorbital margin.Med Sci Monit. 2019;25:5201-5210. doi:10.12659/MSM.915447Özer D, Bölük C, Türk Börü Ü, Altun D, Taşdemir M, Köseoğlu Toksoy C.Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study.Curr Med Res Opin. 2019;35(5):909-915. doi:10.1080/03007995.2018.1532403Effective Health Care Program, Agency for Healthcare Research and Quality.Systematic Review: Acute Treatments for Episodic Migraine.Friedman BW, Mohamed S, Robbins MS, et al.A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide.Headache. 2018;58(9):1427-1434. doi:10.1111/head.13395Migraine Surgery Specialty Center.Why did the nerve block from my neurologist make things worse?.Johns Hopkins.Botulinum Toxin Injectables for Migraines.Chowdhury D, Datta D, Mundra A.Role of Greater Occipital Nerve Block in Headache Disorders: A Narrative Review.Neurol India. 2021;69(Supplement):S228-S256. doi:10.4103/0028-3886.315993
Inan LE, Inan N, Unal-Artık HA, Atac C, Babaoglu G.Greater occipital nerve block in migraine prophylaxis: narrative review.Cephalalgia. 2019;39(7):908-920. doi:10.1177/0333102418821669
Association of Migraine Disorders.Chapter 5, Episode 4: Nerve Blocks for Migraine Disease.
Allen SM, Mookadam F, Cha SS, Freeman JA, Starling AJ, Mookadam M.Greater occipital nerve block for acute treatment of migraine headache: A large retrospective cohort study.J Am Board Fam Med. 2018;31(2):211-218. doi:10.3122/jabfm.2018.02.170188
Haładaj R, Polguj M, Topol M.Anatomical variations of the supraorbital and supratrochlear nerves: Their intraorbital course and relation to the supraorbital margin.Med Sci Monit. 2019;25:5201-5210. doi:10.12659/MSM.915447
Özer D, Bölük C, Türk Börü Ü, Altun D, Taşdemir M, Köseoğlu Toksoy C.Greater occipital and supraorbital nerve blockade for the preventive treatment of migraine: a single-blind, randomized, placebo-controlled study.Curr Med Res Opin. 2019;35(5):909-915. doi:10.1080/03007995.2018.1532403
Effective Health Care Program, Agency for Healthcare Research and Quality.Systematic Review: Acute Treatments for Episodic Migraine.
Friedman BW, Mohamed S, Robbins MS, et al.A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide.Headache. 2018;58(9):1427-1434. doi:10.1111/head.13395
Migraine Surgery Specialty Center.Why did the nerve block from my neurologist make things worse?.
Johns Hopkins.Botulinum Toxin Injectables for Migraines.
Chowdhury D, Datta D, Mundra A.Role of Greater Occipital Nerve Block in Headache Disorders: A Narrative Review.Neurol India. 2021;69(Supplement):S228-S256. doi:10.4103/0028-3886.315993
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