Most headaches are managed with medication and lifestyle change. When attacks are frequent, medication is not tolerated, or the headache arises from the nerves and joints of the upper neck, image-guided nerve blocks and radiofrequency offer relief that medication alone does not. Dr. Kiruthika works alongside your neurologist or physician.
The scalp, upper neck joints and the covering of the brain share nerve pathways, so pain from the greater occipital nerve or the upper cervical facet joints is felt as headache. Migraine is a brain-driven disorder in which these same nerves amplify pain; blocking them can reduce attack frequency. Facial nerve pain arises from the trigeminal nerve and is treated differently.
History and headache pattern first, with neurological examination. A diagnostic nerve block that abolishes the headache confirms a peripheral source. MRI is requested when the pattern or examination is unusual, and a neurologist is involved for primary headache disorders.
Conditions treated
Recurrent, often one-sided throbbing headache with nausea or light sensitivity. Medication is the mainstay. For frequent or chronic migraine, greater occipital nerve blocks reduce attack frequency in many patients [and botulinum toxin injections are offered for chronic migraine — include only if she provides].
Headache generated by the upper cervical facet joints, felt at the back of the head and behind the eye, worse with neck movement. Confirmed by a diagnostic block of the C2–3 joint or third occipital nerve; treated with radiofrequency for lasting relief.
Sharp, shooting pain along the greater or lesser occipital nerve at the back of the head, with tenderness over the nerve. An ultrasound-guided occipital nerve block is both the test and the treatment; pulsed radiofrequency for recurrent cases.
Band-like pressure headache linked to tightness in the neck and scalp muscles. Trigger point injections into the trapezius and suboccipital muscles, with a stretching and posture programme.
Severe, brief electric shocks in the cheek, jaw or forehead, triggered by touch, chewing or brushing teeth. Medication (carbamazepine or similar) is first-line. When it fails or is not tolerated, radiofrequency treatment of the trigeminal ganglion is considered, or referral for microvascular decompression. [Confirm which interventions she performs.]
Headache persisting after concussion or whiplash, often with a neck component. Treated by addressing the neck source — occipital nerve or upper facet blocks — alongside graded rehabilitation.
Occipital nerve blocks take ten to fifteen minutes and require no sedation. Radiofrequency procedures take thirty to forty-five minutes under local anaesthesia with X-ray or ultrasound guidance.
A sudden, severe “worst ever” headache; headache with fever and a stiff neck; headache with weakness, confusion or visual loss; a new headache after 50. These need emergency assessment, not an outpatient injection.
It reduces frequency and severity for weeks to months in many patients; it is not a cure and is used alongside medication.
The injection is placed near the nerve at the back of the scalp, under the skin, using ultrasound. It does not enter the skull.
No. Any change to medication is made with your neurologist or physician.
Typically every few months as needed; radiofrequency is offered when repeated blocks work but wear off.
Trigeminal neuralgia is often mistaken for dental pain. If dental treatment has not helped, a pain assessment is worthwhile.