Chronic Headache Pain Treatment in Delhi

Headache is a common problem. Fortunately a significant proportion of headaches can be managed by commonly used painkillers. In certain types of headaches prophylactic agents are used to reduce the frequency of attacks. However, there still remains a subgroup of patients with difficult to manage headaches despite all measures. For this subgroup pain clinic offers interventions and multi-disciplinary input, over and above the traditional approach of using painkillers. Multi-disciplinary approach helps in addressing concomitant magnifiers/ triggers such as anxiety, depression, altered sleep cycle, medication overuse, life style and poor posture.

In clinical practice, an overwhelming majority of headaches are either a tension-type headache, migraine, cluster headache or medication overused headache. Extra cranial sources of headaches such as nerves, joints and muscles can be easily missed. The term Cervicogenic Headaches is used for headaches originating from cervical spine pathology or surrounding soft tissues. Examples include neck facet or Atlantoaxial joint pathology, headaches secondary to third occipital nerve, supraorbital neuralgia, and occipital neuralgia, sternocleidomastoid and trapezius muscle spasms. These types of headaches may be accompanied by neck pain, stiffness and are commonly undertreated.

Facet Joint Injections & Radiofrequency ablation
Headaches originating from facet joints are more commonly observed in the elderly and after whiplash injury (flexion/extension injuries). Clinical diagnosis is often difficult as the features overlap with other types of headaches. Diagnostic injections can help identify the pain generators in such cases. Pain originating from these joints can be felt in the base of the skull, neck, upper back, mid-back and shoulders. Please follow the link to Facet joint injections to find out more on this treatment.

Third Occipital Nerve Block and Radiofrequency
The third occipital nerve originates from the cervical spine and supplies sensation to a joint in the neck (C2-3 zygapophyseal joint) and a small area at the back of head. This nerve or the joint it supplies can be a source of headaches localised to the back of head on one side. Sometimes the headache can spread towards the top of the head. This occurs more commonly after whiplash injury.

A diagnostic block involving injection of local anaesthetic close to the nerve can help determine if this nerve is the source of your headache. This is performed under x ray guidance. If the diagnostic test is positive then radiofrequency ablation of the nerve can provide long lasting relief.