About Headache and Facial Pain Nerve Blocks
Several nerves of the head and face play a role in headache and facial pain. The occipital nerves run up the back of the head, the sphenopalatine ganglion is a nerve cluster behind the nose, and the branches of the trigeminal nerve supply the forehead, cheek, and jaw. Numbing the right nerve can break a pain cycle and sometimes reduce how often attacks occur.
Dr. Chen uses ultrasound for occipital and trigeminal branch blocks, which lets him see the nerve and nearby blood vessels for more precise placement. The sphenopalatine ganglion block is done through the nose with a thin applicator, without a needle.
Nerve blocks are often combined with other treatments, such as preventive medication, Botox for chronic migraine, and attention to sleep, neck strength, and posture.
What happens during treatment
- 1.
Dr. Chen reviews your headache history, examines the head and neck, and chooses which nerves to target.
- 2.
For occipital or trigeminal branch blocks, the skin is cleaned and a fine needle is guided to the nerve under ultrasound.
- 3.
For a sphenopalatine ganglion block, a soft applicator is placed through each nostril to deliver the anesthetic.
- 4.
You rest briefly and note any change in your pain before going home.
Who may be a good candidate
- People with occipital neuralgia, which causes sharp or shooting pain at the back of the head.
- People with chronic or hard-to-control migraine or cluster headache.
- People with facial pain along a trigeminal nerve branch, including selected cases of trigeminal neuralgia.
Recovery
Most people return to normal activity right away. The treated area may feel numb for a few hours. Some people feel relief within minutes, while others notice fewer or milder headaches over the following days. Blocks can be repeated if they help.
Risks and limits
Common effects include brief soreness, lightheadedness, and temporary numbness. After a sphenopalatine ganglion block, a bitter taste, a numb throat, or mild nasal irritation is common. When a steroid is used, a small area of skin thinning or hair loss at the injection site can occur. Infection and bleeding are rare. Seek emergency care for a sudden severe headache, a headache with fever and stiff neck, or new weakness, confusion, or vision loss.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Headache Blocks
- How long do headache nerve blocks last?
- Relief ranges from days to several weeks or longer, and it varies from person to person. If a block helps, it can be repeated, and it can be combined with other preventive treatments.
- Does an occipital nerve block hurt?
- Most people feel a quick pinch and brief pressure. A fine needle is used, and the procedure takes only a few minutes. Numbness at the back of the head usually follows.
- Can nerve blocks replace my migraine medication?
- Nerve blocks usually work alongside medication rather than replacing it. For some people they reduce how often rescue medication is needed. Any medication changes should be made with the physician who manages your headaches.