By Dr. Myrdalis Diaz-Ramirez, Sarasota PRC
Headaches can be crippling. They can start with or without a history of trauma or illness.
Here are some interventional therapies that have been useful in the treatment of headaches:
- Botulinum toxin (Botox)
Approved by the FDA for the treatment of migraine headaches. This therapy was identified as a potential source of relief after many migraine patients who had the treatment for cosmetic purposes reported improvement of their headaches. The points injected follow a similar distribution of the ones used for the treatment of wrinkles. The effects last between 4-6 months.
- Sphenopalatine ganglion blocks
Can be used in the case of a severe headache attack. Local anesthetic-covered swabs are inserted through the nostrils in the office while the patient is being monitored. At the base of the nose there is a plate through which nerve fiber endings communicate with a ganglion (sphenopalatine). The local anesthetic numbs these fibers, thus blocking the headache temporarily. This can be an alternative to IV medication in the ER.
- Occipital nerve blocks
Can be given in the office to treat pain that starts in the back of the head and goes all the way up on one or both sides to the back of the eye. They can also be used for diagnostic or therapeutic purposes. Steroids can also be injected. The relief is almost immediate and can last for months.
- Trigger point injections with different solutions
Can treat headaches that are due to muscles. Yes, muscles can hurt a lot. Headaches due to this reason are better treated in combination with physical therapy. These are easy to diagnose and treat effectively.
- Regenerative medicine
There is mounting evidence that supports the use of our own blood, cells, and amniotic grafts to treat painful ligaments and tendons. Headache pain often stems from damage in the surrounding tissues, (nerves, muscles, ligaments, joints, etc.) If the headaches are been caused by these problems, we could achieve healing using these more natural methods.
Stem cell therapy triggers a regenerative process in ligaments and cartilage, which in turn alleviates headaches. To accomplish this, blood is drawn, then blood platelets are separated and injected into affected areas. The body then begins the regeneration process.
- Cutting edge technologies
Electricity can be delivered through thin wires under the skin to stimulate nerves that can be involved in the headache process and provide profound pain relief. These peripheral nerve stimulators are now available with external batteries, which make their implantation much easier and hardly any recovery time.
- Facet joint injections, medial branch nerve blocks and ablations
Used for management of the cervicogenic (from the neck) headaches and the famous “whiplash injuries”. These techniques have been used for over 40 years to treat pain related to the little joints of the spine vertebral bodies. The relief the patients obtain is great. Up to 75-80% of the patients who obtain significant relief with the diagnostic injections can obtain long-lasting relief (average of 1 ½ - 2 years) with the ablation (nerve burning).
If you’re suffering from the pain of crippling headaches, you should discuss these alternatives with your pain medicine specialist, so you can enjoy a better life with less pain.
About Dr. Myrdalis Diaz-Ramirez
Dr. Diaz-Ramirez is a board-certified, fellowship-trained pain medicine physician and anesthesiologist with more than a decade of experience in the field. She is a clinical professor at Florida State University College of Medicine, has co-authored and edited multiple book chapters related to pain medicine, and she has been awarded "Top Doctor" in her field by her peers for the past seven consecutive years. Dr. Diaz-Ramirez is bilingual in English and Spanish.
Dr. Diaz-Ramirez practices at Pain Relief Centers’ Central Sarasota location, specializing in Anesthesia/Pain Medicine.
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