Migraine

Saw my Cleveland Clinic Neuro on Wed. He is still trying to find me a pain mgt doc who will treat me (apparently most around here wont touch migraineurs). BUT he did an occiptal nerve block on me while in the office. It has made a HUGE difference. But where he stuck me still hurts pretty bad but I will take it. Right now I am off all maintence meds because he feels we have ran the long list of them and with all my side effects they are causing me more harm than good.

Keeping my that you stay pain free.

I agree- thank god for occipital nerve blocks... they're just a godsend to me too! Glad it helps you as well!

I agree--YAHOO for occipital nerve blocks! Without them, I would truly be lost!

I'm due for another next Friday...

Patiently counting the days!!

jenny

Here's hoping those blocks do the trick for a longgggg time!

Hi millsy!

I currently get occipital nerve block injections and trigger point injections all at once (about 15 injections?).

Before I had my first one, I was told that some people get a few weeks of relief, some less.

A while back, I had injections from one doctor (a HA specialist I was VERY unhappy with) and didn't experience much relief at all.

But my current HA specialist is FANTASTIC with them! When he did my first one, I had 10 days of COMPLETELY symptom-free time! After that, I had some aura, nausea and pain, but at a much lower level than normal.

My last nerve block was done a bit differently--we concentrated some trigger point injections at my jaw and neck, as these tend to get really sore during my migraines! This block was helpful but not as good as the first. If I remember correctly, it lasted about a week...

Results vary! One bit of advice, though...PLEASE be sure you see someone who is experienced in doing occipital nerve blocks for migraine!! As you can tell from my experience, a good doctor REALLY makes a difference with them!!

And remember, nerve blocks are only temporary! You still have to look toward an effective preventive regimen for long term relief (once your anemia is under control)!

Let us know what you decide to do!!

jenny

Just with my last menstrual migraine cycle starting 3/1/8, I started to have severe pain in the back of my head/neck. In the beginning it went into my shoulders. I am still having severe pain.

When I called dr. headache specialist about it on 3/6/8, he put me on a 3 day course of a super-de-duper muscle relaxer. It took the pain down somewhat during those 3 days, but now it is back to horrid! I cannot sit without pain in my neck, much less sleep! Ha!

He mentioned on my last phone call if the m. relaxer didn't work he'd have me get a nerve block. I'm calling him in the morning during his calling hours to relay how I'm doing.

At this point, I'm up for anything. He's going to have me go to a dr. who does all his blocks for him. But it sounds like these nerve blocks really hurt.

What are they exactly? He told me it was a coctail of a steroid & an analgesic. But, where is it administered? In my neck, my head? I'm assuming it is via a needle. Do you feel immediate relief from the pain?

Thanks guys!

Kelly

Hi Kelly,

Well, I'll tell you what I know from my experience...but remember I'm certainly not a doctor...

When I get nerve blocks, they are for migraine, jaw, and neck pain. My shots have always contained lidocaine and a steroid (not sure what steroid...I've never asked!). The lidocaine immediately numbs the area, so yes--I do have immediate relief.

I get a combination of a Greater Occipital Nerve Block and trigger point injections. The Occipital Block involves injections at the base of my skull/top of my neck. That's where the occipital nerve is found. I can feel the medication being injected and the pain relief kind of moving up the back of my skull...

The trigger point injections can be done in different ways for different people, depending on the location of your pain. I've had injections near my temples, eyebrows, jaw, and the back of my neck. your doctor will determine the placement of these injections to be sure he hits your most painful areas.

As far as the shots themselves, yes--they are painful. Yep, they are shots given with a small needle. I find the ones in my eyebrows are the worst (pinching-wise) and those in my temple tend to burn when the injections are done. During my last nerve block, I had about 20 injections--that's the most I've had at one time.

The evening of the nerve block and the following day, I usually am sore. It feels kind of like a bruise in the area of the injections. But it passes pretty quickly.

But I MUST tell you that, despite the pain, the nerve blocks are definitely worth it for me! I am more than willing to endure a few moments of pain when the nerve blocks bring me many pain-free days!

Hope that info helps!!

jenny

I'm also a Occipital Nerve Block person.

I was going to write a long thing, and then read Jenny's post. Bingo- that's a wonderful description!

I don't get anything done on the front of my head- just neck and shoulders. For me, it depends on which PA in the office does the block. One has a VERY light touch, but the block doesn't seem to last as long. Usually when he does it, I don't get as out of sorts for the day... The block that he does lasts about a month.

The other has a heavier hand, but I'm on month 2.5 since my last block, and I'm not counting the days to the next one.

I usually ice the neck and shoulders after the block, and don't get as "bruised" and sore as otherwise I would. Othertimes, I use Biofreeze immediately after the procedure and don't ice it until I get back to work- an hour drive from the HA specialist. This is my new strategy, and I've found that it's much easier than driving with icepacks on my neck and shoulders!

As you might have guessed, I'm a big fan of the Occipital nerve block.

Oh Jenny & Jamie!

Thank you SO much! I have missed this family so much as I've been gone a bit and you both just showed why.

Thank you for all the information.

Jenny, your description was a great help.

Jamie, your suggestion about the ice is great.

I'm looking forward to getting moving with it. I'm a touch nervous of having needles in my head, but knowing a little of what is going to happen really helps me. And I'm ready for anything to help so hopefully this will!

Kelly

Did any of you have trouble getting insurance to cover your nerve blocks? I'm thinking about discussing this as an option with my specialist when I see her since the Botox was declined and I'm still working on appealing it...

I pretty sure my nerve blocks were just billed as part of the office visit.

I worked for Blue Cross/Blue Shield for several years as a review nurse and we never reviewed any type of nerve blocks. It was an auto type payment procedure. Now, we reviewed every request for Botox and was very strict approving them because of cost. We had a set of criteria and if the patient did not meet that criteria the physicians would deny it.

So my guess is the cost is minimal for nerve blocks- I know my MD told me its a mix of Lidocaine and steroids and I know those meds are cheap.

Hi MJ and Hedi,

I have BCBS and I needed to have a prior authorization for my nerve blocks. And they only approve them for 6 months at a time...I had them denied at one time, but we appealed to get the ultimate approval. But from my experience, nerve blocks are much easier to get than Botox (insurance-wise).

Actually, the nerve blocks are not all that cheap! I get the occipital block and trigger point injections in my eyebrows and temples. I just looked at my receipt from the appointment I had last Friday...The cost for all of my shots was $1500. And I usually get them done every 6 weeks.

Hope that helps!

jenny

Thanks Jenny and Hedi, that does help. It's so hard to tell what insurance will (or won't) make a big deal out of sometimes but I think it's worth it to ask my specialist about this when I see her in a few weeks. Thanks!

I've been getting occipital nerve blocks for probably two years now and although they are painful, I agree with everyone else that said they are definitely worth it. It has been my experience that my migraine breaks approx. two hours after the injections but the tenderness and swelling at the injection site lasts approx. a week. I've also noticed hair loss at the injection site. It seems that once my neurologist injects the lidocaine, I don't feel the steroid injection. He has told me that you can only have this procedure done no more than 1 every 30 days, but he won't give one every 30 days on a repeated basis. Are trigger point injections Botox? I get 16 Botox injections every 3 months and usually get a nerve block at the same time. It just makes sense to be in misery with both kinds of injections at the same time instead of splitting them up. We didn't have to get any pre-auth for the nerve blocks but did for the Botox.