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Chronic Headache: a Review of Interventional Treatment Strategies in Headache Management

  • Ruchir Gupta
  • Kyle Fisher
  • Srinivas PyatiEmail author
Chronic Daily Headache (SJ Wang, Section Editor)
  • 114 Downloads
Part of the following topical collections:
  1. Topical Collection on Chronic Daily Headache

Abstract

Purpose of the Review

To provide an overview of current interventional pain management techniques for primary headaches with a focus on peripheral nerve stimulation and nerve blocks.

Recent Findings

Despite a plethora of treatment modalities, some forms of headaches remain intractable to conservative therapies. Interventional pain modalities have found a niche in treating headaches. Individuals resistant to common regimens, intolerant to pharmaceutical agents, or those with co-morbid factors that cause interactions with their therapies are some instances where interventions could be considered in the therapeutic algorithm. In this review, we will discuss these techniques including peripheral nerve stimulation, third occipital nerve block (TON), lesser occipital nerve block (LON), greater occipital nerve block (GON), sphenopalatine block (SPG), radiofrequency ablation (RFA), and cervical epidural steroid injections (CESI).

Summary

Physicians have used several interventional techniques to treat primary headaches. While many can be treated pharmacologically, those who continue to suffer from refractory or severe headaches may see tremendous benefit from a range of more invasive treatments which focus on directly inhibiting the painful nerves. While there is a plethora of evidence suggesting these methods are effective and possibly durable interventions, there is still a need for large, prospective, randomized trials to clearly demonstrate their efficacy.

Keywords

Cervicogenic headache Peripheral nerve stimulation Radiofrequency ablation Greater occipital nerve block Lesser occipital nerve block Sphenopalatine block 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Ruchir Gupta, Kyle Fisher, and Srinivas Pyati declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyStonybrook UniversityStony BrookUSA
  2. 2.Department of AnesthesiaDuke UniversityDurhamUSA
  3. 3.Department of AnesthesiologyDuke University School of Medicine and Durham Veterans Affairs Health SystemsDurhamUSA

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