Headaches are a common problem and are one of the most common medical complaints for outpatient office visits and emergency department visits. Headaches can occur anywhere around the head and can even begin in the neck and travel into the back and top of the head. There are several different types of headaches and the management for each one is different.

Migraines

Migraine is an extremely common neurobiologic headache disorder that is due to increased central nervous system excitability. It is characterized by episodic attacks of headache and associated symptoms. The migraine attack can consist of premonitory, aura, headache, and resolution phases. Migraines can be associated with light sensitivity, nausea, and vision changes. This type of headache can be very debilitating and can severely interfere with daily functioning and productivity.

Tension Headaches

This is the most common type of headache. Tension headaches can begin at any age, but onset during adolescence or young adulthood is most common. The onset of the headache is usually gradual, often after or during times of stress, and the pain is typically worse late in the day. The pain can be nagging, tight, or vise-like biolateral pressure in the forehead, temples or back of the head.

Occipital Neuralgia

Occipital Neuralgia is a unilateral or bilateral pain in the back of the head in the distribution of the Occipital Nerves.  It is described as a sudden stabbing or shooting pain that is usually associated with tenderness over the affected nerve(s) and sometimes accompanied by a decreased sensation or numbness in the affected area.

Cervicogenic Headaches

Another common cause of headaches is pain emanating from the neck. The joints in the neck (called facet joints) can develop arthritis and also cause surrounding nerve irritation leading to pain. Cervicogenic Headaches can be either unilateral or bilateral with patients typically describing the pain as a constant throbbing and aching with the feeling of a stiff neck. It is commonly caused by whiplash injuries from car accidents.

Conservative Measures:

• IV infusion therapy

• Medical marijuana

• Botox injections

Minimally Invasive Procedures:

• Occipital nerve block

• Stellate ganglion block

• Nerve ablation

• Spinal Cord Stimulation