Headache Treatment

6 Jun 2017 · 2 min

Watch on YouTube

2:02

A practitioner demonstrates an occipital nerve block for headaches and migraines. The procedure uses xylocaine and Depo-Medrol injected near the occipital nerves at the back of the skull, with numbness spreading to the hairline indicating success. Results typically reduce headache intensity, though repeat treatments may be needed.

Chapters

So today I'm going to be doing an occipital nerve block for headaches and migraines that radiate from the back of the head. There are 4 occipital nerves if you split the head in half. There's 2 greater occipital nerves and there's 2 lesser occipital nerves that exit out the muscle right here. I'm going to measure out the distance. Here's the mastoid process and here's occipital protuberance, and 1/3 the distance is the greater occipital nerve distribution. 2/3 the distance, located right around here, will be the lesser occipital nerve. This is a combination of preservative-free xylocaine and Depo-Medrol, which is a steroid. It's going to help decrease inflammation in this area. So I'm going to enter in here. I'm going to hit actually her occipital bone. I'm going to aspirate, make sure I don't get any blood, and I'm going to inject 1 cc in here. I'm going to fan out a little bit to the side. I can feel her muscles super tight. I'm going to inject 1 cc this way, and then I'm going to fan in the other direction. Now I'm injecting the other direction, aspirating and injecting. I have to be careful because next to the artery— I mean, next to the nerve is the artery. Inject for the lesser occipital nerve. I'm going to inject here, aspirate and inject. Now, success of this block will be numbness in the distribution of the nerve. So the lesser occipital nerve will radiate in a distribution around the ear, wrapping around the ear. The greater one goes up The forehead to where— we're all done. I'm just going to massage it in a little bit, and then we're going to start to test and see if this feels the same as that. Does it feel the same? Already feeling numbness in this area, which is just distal to where I injected. And slowly over the next few minutes, that numbness will start to— So the numbness will increase all the way to the ends of the nerves, which is about her hairline. The occipital nerve block, which is what she just had, will help decrease the intensity of her headaches and decrease the frequency of her headaches. She may have to have this repeated.