Types of Nerve Blocks
There are a variety of different procedures and types of head and facial nerve blocks that can be useful in pain treatment.
Occipital Nerve Block
Patients suffering from chronic pain in the back of the head may be candidates for occipital nerve block. The occipital nerves run from the upper portion of the spine to the back of the skull. The tissues surrounding these nerves may become inflamed, compressing the nerves, and creating pain. An occipital nerve block is an injection of medicine given close to the occipital nerves. A local anesthetic is applied to the back of the head, then a small needle will be inserted to place the medication close to the occipital nerves. Patients report sensations of pressure or tingling during the procedure, especially when the needle is close to the nerves. Relief from pain can be almost instant and can last from several days to several weeks.
Sphenopalatine Ganglion Block
The sphenopalatine ganglion is a collection of nerves in the middle of the head that branches into the lacrimal glands, the paranasal sinuses, and parts of the nasal cavity and pharynx. Patients who suffer from cluster or migraine headaches or who have experienced trauma, infection, or disease in the sphenopalatine ganglion region may benefit from an anesthetization of these nerves for pain relief.
A numbing solution is applied to reduce discomfort during the procedure. Then the doctor will use fluoroscopy to guide the small needle to the exact point where the medicine is needed, often through the back of the nasal cavity, though sometimes the side of the face. The pain relieving medication is injected into the ganglion, and patients begin to feel relief anywhere from right away to several days.
Trigeminal Nerve Block
The trigeminal nerve is responsible for sensations in the face and with functions such as chewing, biting, and swallowing. As its name suggests, the trigeminal nerve has three divisions of nerves which branch all over the head, the face, and the upper part of the neck. Atypical pain in the face due to things like trigeminal neuralgia or herpes zoster (shingles) pain can be relieved by a trigeminal nerve block.
Using x-ray (fluoroscopy) to guide the needle, the doctor injects pain relieving medication at the trigeminal nerve branch. The procedure only takes about 10 minutes and many patients feel relief immediately. However, it is not uncommon for pain relief to begin several days after the injection.
Temporomandibular Joint Injection
The trigeminal nerve branches extend to the temporomandibular joint, or jaw. The nerves are essential to the functions of the jaw, including biting and chewing. The causes of pain in the temporomandibular joint are varied and may include stress, grinding the teeth, or osteoarthritis.
An injection of anesthesia is given at the location of the joint. Tingling or pressure may be experienced as the following injection of pain relief medication is then given. The entire procedure normally takes less than 10 minutes to perform.
Supratrochlear Nerve Block
The supratrochlear nerve is a very small nerve which branches from the trigeminal nerve. This nerve provides sensation to the forehead and upper eyelid. When this nerve is damaged, painful headaches can occur.
A patient undergoing a supratrochlear nerve block will be given a numbing solution over the area where the injection of pain medication is to be administered. Then the doctor will direct a very small needle next to the supratrochlear nerve and inject the medicine. The procedure should take less than 10 minutes to perform.
Supraorbital Nerve Block
The supraorbital nerve is a very small nerve branching from the trigeminal nerve. It provides sensation to parts of the scalp, forehead and eyelid. Patients experiencing facial muscle spasms, trigeminal neuralgia, TMJ or other conditions may discover that the supraorbital nerve is irritated, even causing pain.
To apply a supraorbital nerve block, the doctor will first apply a numbing solution to the area of the injection. Then the doctor will use a very small needle to inject a small amount of pain medicine next to the nerve. The whole procedure should take less than 10 minutes.
Couple years back, your team helped me ATN. The surgery of MVD dropped pain 60%. Now appears a secondary eye pain may be Supra Orbital Neuralgia. Just had the short term testing of injection of lidocane and steroid into Supra orbital and intra orbital nerve. Pain eliminated immediately and stayed below level 3 for 6 days. My impression is the Block is solid confirmation of Supra Orbital Neuralgia. I want to carry to next step in treatment. I have tried all the pills with no success and it appears options left are either ablasion or stimulators that I assume scramble nerve signal. I live in Jamestown, NC.
I appear to be at point that the decision process on treatment is hitting a wall. Can you advise info. of success, providers, and best direction to obtain longer term results if possible.
Thanks for help
Ron