Occipital Nerve Blocks

 A sphenopalatine ganglion (SPG) block is a procedure that uses a local anesthetic to block nerve signals from the sphenopalatine ganglion, a nerve cluster in the back of the nasal cavity, to alleviate pain from certain headache and facial pain disorders, including migraines and cluster headaches. The anesthetic can be applied through a nasal spray with a sphenocath device and cotton-tip applicator, with the goal of providing rapid relief from severe headaches. 

Botox is an FDA-approved preventive treatment for adults with chronic migraine, defined as having headaches 15 or more days per month. The treatment is administered through a series of injections into shallow muscles around the head, neck, and shoulders, and it is known for being both safe and effective.

 Instead of treating a migraine in progress, Botox works to prevent future headaches. The mechanism is thought to involve blocking pain signals before they can reach the central nervous system. 

• Blocks neurotransmitters: Botox is injected near nerve endings, where it stops the release of pain-signaling chemicals like calcitonin gene-related peptide (CGRP).
• Reduces pain signaling: By blocking these signals, Botox prevents the activation of pain networks in the brain. 

 Botox is not for everyone with migraines. You may be a candidate if: 

• You are an adult (18+) with chronic migraine, experiencing 15 or more headache days per month.
• Your headaches last four hours or longer on those days.
• You have tried and failed to respond to at least two other preventive migraine medications, such as anti-seizure drugs, antidepressants, or blood pressure medications

 The most common side effects are usually mild and temporary. These may include: 

• Neck or shoulder pain
• Headache
• Muscle weakness
• Drooping of the eyelid or eyebrow 

Serious side effects are rare but can occur, such as difficulty breathing or swallowing. Be sure to discuss all medical conditions and medications with your doctor beforehand, especially if you have neuromuscular conditions 

Because Botox is FDA-approved for chronic migraine for 18+ years, it is covered by most insurance plans, including Medicare and Medicaid. Many insurance providers require that patients first try other preventive medications.