Headaches Treatment Performed by Award Winning Doctors in Scottsdale, Gilbert, Glendale, and Chandler, Arizona
Headaches are a very common ailment. They are most often described as pain in the head or upper neck, and can be felt in specific areas of the head or face, or at the base of the skull. Headaches can be chronic, a constant source of pain and discomfort, or acute, with a sudden onset, causing sharp, stabbing pains. Some types of headache occur consistently at certain times of day (“episodic” headaches).
It is estimated that 45 million people in the U.S. suffer from recurrent headaches. Acute headaches are classified as pain or discomfort experienced anywhere within the head or neck that has a very sudden onset, and rapidly gets worse afterwards.
Many types of headache may feel as though they are coming from, or are driving deep into, the brain. However, the brain itself does not actually feel pain (i.e. it does not have the specific biological receptors for pain). Headaches are caused by an irritation (chemical or physical damage) of the many structures surrounding the brain, including the skull, muscles, nerves, arteries, veins, subcutaneous tissue, eyes, ears, sinuses, and mucous membranes. This is usually the result of inflammation, injury, or disease. Certain major nerves transmit this information, i.e. the fact that something is causing pain, back into the brain, which is the basis of this effect.
Causes and Pathophysiology of Headaches
Headache pain is transmitted by nerves in the membranes inside the skull, or major nerves radiating out of the brain. These nerves may have incurred injuries or damage from inflammation or irritation. This is mostly linked to headaches that are chronic or recurrent. Headaches are divided into primary and secondary categories. Secondary headaches result from damage to nerves or other tissues anywhere in the body as a result of another condition or illness, whereas primary headaches are a condition caused by direct damage to the nerves in the brain or skull. Some headaches arise for no diagnosable reason at all, however. These are called idiopathic headaches.
Headaches centered at the base of the skull or top of the neck can be traced to the occipital nerve. Migraine headaches can be attributed to a number of important nerves in a network called the trigemino-cervical complex. Other migraine symptoms, such as photophobia (aversion to light), sonophobia (aversion to sound), and extreme episodic pain can originate from this complex. Episodic migraines are associated with damage to the trigeminal nerve, a major nerve in the brain. Some cluster headaches can also be traced to this nerve, though they are thought to result from a different mechanism of damage to that associated with migraines. Other cluster headaches can also be attributed to a group of nerve endings in the skull called the sphenopalatine ganglion (SPG). Some headaches in or around the nasal area (often called sinus headaches) can also be traced to the SPG.
Treatments for Headaches
Nerve blocks, if successful, are also effective medium-term treatments for headaches. Occipital, trigeminal, and SPG blocks are often indicated for cluster and chronic migraine headaches. They can achieve pain relief lasting from weeks to months between treatments. Trigemino-cervical blocks are applied to the upper neck. SPG blocks must be applied by inserting a thin needle into the nasal or oral passages, and onward into its location in the skull. The anesthetic will then be injected through this needle.
Other Direct Nerve Treatments
If headaches prove resistant to this treatment, the next step is often radiofrequency ablation (RFA) of the affected nerves. In this procedure, thin probes are inserted at the desired location. These probes then deliver radiofrequency waves (heat) to the nerve to disrupt it and thus prevent it from sending pain signals to the brain. SPG ablation has been shown to be effective in treating chronic nasal or sinus headaches, and occipital RFA was found to be as effective as blocks in alleviating pain.