Migraines are headaches that cause intense throbbing and pulsing sensations in the head commonly accompanied by nausea and vomiting. The sufferers may also experience extreme sensitivity to light and sound. These headaches may last for many hours or even days in some cases, completely incapacitating the sufferer ([Migraine: treatment and prevention] 2014).
Often these headaches are preceded by warning symptoms, flashes of light, dark spots, or tingling in the arms or legs. Some patients also experience what is commonly called an aura, which is described as a ring of light around people and objects. Anyone may experience migraines but it seems that women are more susceptible to them. How Common are Migraine Headaches?
Collapse According to the US Dept of Health, 18% of women and 8% of men experience migraines. This makes it the most prevalent long term neurologic condition. In all, it is reported that 36 million Americans (12% overall) have migraines. One fourth of those who suffer from migraines have what is known as chronic migraines. This is defined as migraines that affect an individual over 15 days per month for at least six months. What are the symptoms of migraines? Expand Often warning signs will occur a couple days ahead of time, these include:
- Intense food cravings
- Neck stiffness
- Bright spots or flashes of light
- Vision loss
- A feeling of pins and needles sensations in an arm or leg
- Uncontrollable yawning
- Difficulty with speech or language (aphasia)
- Increased Hyperactivity
- Severe Irritability
More symptoms include, localized pulsating, throbbing, pain occurring on one side or both sides of your head, and sensitivity to light and sound, nausea, vomiting, blurred vision, lightheadedness, dizziness, and fainting (Temporomandibular Disorders and Headaches 2014).
If you are suddenly struck with any of the following symptoms; sudden, severe headache, a headache accompanied by fever, a stiff neck, become disoriented or confused, seizures, blurred or double vision, weakness or numbness, difficulty speaking, you should seek medical attention promptly. How are migraines diagnosed? Expand Diagnosis of migraines can be difficult; to determine if you are actually suffering from migraines it is necessary to rule out other causes.
This will require blood tests and CT scans and MRI’s to rule out other causes. If the doctor suspects other conditions, a lumbar spinal tap may be ordered. That’s what is most interesting about diagnosing migraine headaches. There is no definitive test, and it relies mostly on the patient’s subjective symptoms. How do you treat this condition? Expand There is no cure for migraines, but the symptoms can be treated.
This usually involves oral medications, Aspirin, Tylenol, Ibuprofen, anti-seizure medications and opioid analgesics, among others, can be used to help relieve the symptoms. But for chronic sufferers that just may not be enough; they may require a more direct approach by means of an occipital block. An occipital nerve block is procedure where pain relieving medications are injected in the greater and lesser occipital nerves located at the base of the skull.
An additional treatment option is Botox injections into the head and neck area. This treatment has been FDA approved for those suffering with chronic migraines. The FDA approved Botox for migraines based on a large study showing the procedure decreased significantly both the frequency and severity of migraines in treated patients. The procedure may be repeated every three months as needed and it only takes about thirty minutes.
What are expectations when a patient gets treatment? Expand When a patient receives an occipital nerve block they can expect to experience lasting relief from their migraine headaches that may last months. The same goes for Botox injections. Either of these procedures may be repeated every few months with the expectation that the pain relief achieved will be received with the repeat procedure.
How is the occipital block procedure/treatment performed? Expand The patient is most often sat with the head bent forward or lying face down. The area to be injected is cleaned and then a topical anesthetic is used to numb the skin and underlying tissue. Usually prior to the numbing the patient is asked to show the point of maximal tenderness and that is where the injection is placed.
A needle is then inserted into the area and a mixture of local anesthetics and corticosteroids are then injected into the area. This is done on an outpatient basis and the procedure typically takes less than a half hour to perform. If necessary, the procedure may be repeated every few months. Or the patient may receive a radiofrequency ablation which can provide longer term relief.
How long do the benefits of an occipital nerve block or Botox injections for migraines last? Expand Many patients will experience an immediate relief from the local anesthetics; this usually wears off in a few hours. It may take a day or so for the maximum benefit of the injection to be realized. Once the steroid medications take effect the relief is often long lasting, providing relief for many weeks, to several months.
When it comes to migraines and occipital blocks, studies have also shown an 85% effectiveness rate for relief, which may include up to six months of relief (Anthony M. Headache and the greater occipital nerve. Clin Neurol Neurosurg. 1992). For chronic migraines, the Botox injection study that prompted FDA approval was performed on over a thousand patients. The majority of patients experienced a reduction in the severity and frequency of migraines, with the results being sustained for three months on average.
What risk or side effects are there? Expand Side effects are minimal, often the patient will have minimal bruising and swelling in the injection area. In rare cases infection may occur but keeping the area clean will minimize this risk. If you suffer from migraine headaches discuss with your Chicago pain management physician if an occipital nerve block or Botox injection may be right for you.
Premier Pain & Spine offers both medical and interventional treatments for migraine headaches. This includes abortive and prophylactic medications, along with various injections. These include both occipital blocks and Botox among others. Most insurance is accepted at the seven locations, call today (847) 519 4701.
“Dr has really helped with migraine and pain reduction. conservative quality doctor and staff” – Brian S.