Nerve Blocks for Migraine

I have lived with episodic migraine since puberty. However, after an accident six years ago, I have chronic intractable migraine disease. I’ve tried numerous migraine abortive options to try and break an acute attack — including different therapeutic drug classes (e.g., triptans, gepants, ditans, NSAIDs, dihydroergotamine and more) and modes of administration (e.g., pills, intranasal and intramuscular). However, no one particular therapeutic drug has proven to be as effective as nerve blocks, the one foolproof trick that usually helps me break an acute attack. 

What are Nerve Blocks?

Nerve blocks are injections of a numbing medication such as lidocaine or bupivacaine into various locations around the head to block nerve pain signals. I normally receive injections around my head like a “crown” as my doctor as describes it, to block various nerve points around my skull. 

Different types of nerve blocks include:

  • Frontal region: right above the eyes
  • Temporal region: the sides of your head on your temples 
  • Occipital: the greater, the lesser and the third occipital nerves by the groves underneath your head
nerve blocks

Auriculotemporal

nerve blocks

Posterior Auricular

nerve blocks

Supratrochlear

My Experience

I go in for my scheduled or emergency appointment with a severe migraine attack with my headache specialist or pain management doctor. A neurologist can also perform nerve blocks. They first go over any questions I may have such as any side effects or any discomfort I may feel. I get the nerve blocks targeted at the particular spots where I feel the most pain.

The doctor or nurse will draw up the numbing medication into a syringe. The injection site is cleaned thoroughly with alcohol swabs. The physician can angle their hands as to block my eyes which may help others who are needle sensitive, so I do not see the needle and quickly injects the numbing medication into the various nerve block locations. It is a quick process and is over before I know it. 

Sometimes I may experience a small amount/spot of bruising, but that is minor and goes away in a few days. 

Do I Bleed After Receiving Nerve Blocks?

Sometimes they do bleed a bit, but the doctor has gauze on hand to hold pressure and stop the minor bleeding from the injection site.  

Any Restrictions? 

I am able to return to normal activities that day. Usually, my migraine attack resolves to a low to minimal level of pain after the nerve blocks. 

Sometimes there is a bit of swelling after the fact, where some of the numbing medication “pools” in an injection spot, but that dissipates quickly as it is absorbed into my body. 

Do Nerve Blocks Hurt?

No, they feel like a little tiny pinch. I am a bit more sensitive above my eyes, but they are much more tolerable than the actual pain of migraine attack.

Written by:
Nicole Safran
Patient Advocate

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