The utilization of nerve blocks for chronic migraine is well reported. The use of autonomic blocks such as the SPG Block or Sphenopalatine Ganglion Block to treat and prevent chronic daily headache, migraines and other aotunomic cephalgias has been universally accepted as powerful treatment alternatives.
This new article reports on the effectiveness of Greater Occipital Nerve Block for treating and preventing chronic migraine.
This article reports that Greater Occipital Nerve Block was “found to be effective, safe, and cost-effective for the treatment of CM.”
While this study focused on a single treatment I strongly believe the best treatment for chronic migraines is a combination of techniques including Physiologic orthotics, SPG Blocks, Greater Occipital Nerve blocks and trigger point injections.
Reducing the nociceptive input to the brainis the best way to change the chemical and neurotransmitter balance in the brain. I have included the PubMed abstract of this new article below:
Acta Neurol Scand. 2015 Mar 13. doi: 10.1111/ane.12393. [Epub ahead of print]
Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double-blind, and placebo-controlled study.
Inan LE1, Inan N, Karadaş Ö, Gül HL, Erdemoğlu AK, Türkel Y, Akyol A.
Author information
Abstract
OBJECTIVES:
We aimed to assess the efficacy of greater occipital nerve (GON) blockade at chronic migraine (CM) treatment.
MATERIALS AND METHODS:
Patients with CM were randomly divided into two groups of 42. GON blockade was administered four times (once per week) with saline in group A or bupivacaine in group B. After 4 weeks of treatment, blinding was removed; in group A, GON blockade was achieved using bupivacaine, while group B continued to receive bupivacaine, and blockade was administered once per month, then followed for 2 months. Primary endpoint was the difference in number of headache days, duration of headache, and pain scores.
RESULTS:
Seventy-two of 84 patients completed the study. After 1 month of treatment, number of headache days had decreased from 16.9 ± 5.7 to 13.2 ± 6.7 in group A (P = 0.035) and from 18.1 ± 5.3 to 8.8 ± 4.8 in group B (P < 0.001), (P = 0.004, between groups); duration of headache (hour) had decreased from 24.2 ± 13.7 to 21.2 ± 13.4 in group A (P = 0.223) and from 25.9 ± 16.3 to 19.3 ± 11.5 in group B (P < 0.001), (P = 0.767, between groups). VAS score decreased from 8.1 ± 0.9 to 6.7 ± 1.6 in group A (P = 0.002) and from 8.4 ± 1.5 to 5.3 ± 2.1 in group B (P < 0.001), (P = 0.004, between groups). After blinding was removed (in 2nd and 3rd month), group A exhibited similar results like group B in 3rd month.
CONCLUSIONS:
Our results suggest that GON blockade with bupivacaine was superior to placebo and was found to be effective, safe, and cost-effective for the treatment of CM. According to our knowledge, this is the first randomized, multicentre, double-blind, and placebo-controlled study in the literature in this field of work.
