The most common nerve block for headaches is given in the neck, treating the greater occipital nerve which goes up from the neck and covers a large part of the back of the head. We give cortisone to reduce swelling and pain in the area for the next couple of months. We also mix the cortisone with local anaesthetics (unless you’re allergic) which will give an extra numbing of the area during the first day or so.
Doing nerve blocks too many times or too frequently can makes them lose effect, it can also lead to hair loss or skin changes around the injected area. We therefore typically only give them a few times with 3-6 months apart, e.g. while waiting for long term treatment to take effect.
Sometimes we use nerve blocks at other areas to treat facial pain.
Greater Occipital nerve block, showing what the muscles and nerves look like under the skin.