Headache / Migraines

Headache / Migraines

Headache / Migraines

Headache / Migraines

In Toronto, migraines are a common type of headache and affect a significant portion of all Canadians.

A migraine headache can be described as an intense pounding of throbbing pain that is experienced on the head.

It is usually associated with light or sound sensitivity, nausea and vomiting. Other symptoms that arise from a migraine headache include abdominal pain, appetite loss, heat and cold flashes, fatigue, paleness, blurred vision, dizziness and diarrhea. The frequency of migraines can vary from less than once per month to four or more times per month, with a gradual onset and resolution. A migraine can typically last between four hours to three days.

The exact cause of migraine headaches is unclear, however there are likely genetic factors that predisposes migraine sufferers to sensitivities such bright lights, fatigue, emotional stress, food, menstrual periods and so on. The physiological cause behind a migraine headache is the constriction and dilation of blood vessels that lead to the release of inflammatory factors and pain.

Although Toronto headache sufferers may have a chronic condition, most people are able to reduce the occurrence of headaches by avoiding specific situations or triggers, employing effective stress management techniques and maintaining a healthy diet and sleep schedule.

Peripheral Nerve Blocks (PNB) are a useful tools in treatment and prevention for a variety of headache disorders, in addition to commonly known over-the-counter medications such as Aspirin, Tylenol, or Ibuprofen. The effects of the PNB can last. The pain felt during a headache is caused by a group of nerves, generally called a plexus of ganglion, and can be eliminated when a signal block is delivered. The blockage is an injection composed of nerve-numbing medications and temed a “nerve-block”. The medicinal substances can include steroids to reduce inflammation, and local anesthetics such as lidocaine to reduce pain.

Having been employed for many years in the clinic as a treatment for headaches and migraines, PNB injections contain medications that are selective and target a specific nerve as an effective way to diagnose, treat and manage pain.

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How should I prepare for a PNB?

A motivated mindset and a positive attitude are more important than most people think, but PNBs provide pain relief in a simple convention fashion. There are no special preparations required prior to the procedure.

How is a PNB procedure performed?

In Toronto, Peripheral nerve block procedures are done as an outpatient basis. However, if patients do require admission following the procedure, arrangements can be made.

A PNB injection will only take a few minutes to administer. The Doctor will identify the target spots for the needle, either using landmarks and palpation or imaging diagnostics. The treatment areas will be cleaned with an anti-septic solution before the insertion of the needle. When the needle is being administered, you will feel a “pinch”. It must be inserted at a certain depth to effectivley deliver the medication to the problematic nerves, and more than one injection may be required depending on the condition.

After the injection, you will feel some pain relief at the treated site. The duration of pain relief improves over time, and the time between injections is increased by weeks.

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Side effects and associated risks with Toronto PNB.

Even though a PNB is a simple procedure, there are potential risks and side effects associated with it, such as:

  • Elevated blood glucose levels
  • Rash and itchiness
  • Weight gain
  • Soreness at the site of injection
  • Bleeding

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The different types of PNB for a headache


  1. Occipital nerve block:

An occipital nerve block (ONB) is an injection containing a steroid with other medications, targeted towards the greater and lesser occipital nerves that are located at the base of the skull, just above the neck area.

An ONB is administered for patients who experience chronic headaches that arise from the neck or base of the skull. The irritation or inflammation of the occipital nerves that reside in this area can cause pain to arise on side of the head and extend forward to the top of the head, the temple or forehead. Serving as a route for the pain to travel, blocking the occipital nerves is a good target for the treatment of certain headaches and migraines.

  1. Supraorbital nerve block:

A supraorbital nerve block is a nerve block injection that provides analgesic effects to certain regions of the face. The supraorbital nerve is a collection of nerve fibers that form from the frontal nerve and transmits sensory signals to the forehead, upper eyelid and anterior scalp.

A supraorbital nerve block is performed as an outpatient procedure to provide therapeutic relief that lasts from weeks to months and can be done under ultrasound guidance to ensure safety.

  1. Infraorbital nerve block:

Like a supraorbital nerve block, an infraorbital nerve block (INB) is an injection that also accomplishes regional anesthetic and analgesic effects of the face, without causing any tissue distortion. The infraorbital nerve supplies sensory innervation to a considerably large area, including the lower eyelids, the side of the nose and the upper lip.

An infraorbital nerve block can successfully block the signals that cause chronic facial pain that occurs between the lower eyelids and the upper lip.

  1. Trigger point injections:

Trigger points play a large role in most chronic and acute headaches and therefore, therapeutic relief can be achieved by targeting these areas. A trigger point is a common term for the stress-induced knots found in the neck and back that cause tightness in the head and scalp, leading to frequent migraines and headaches. The elimination of trigger points, or the desensitization of them, can provide pain relief to those experiencing discomfort.

A trigger point injection is an injection of an analgesic, lidocaine, in the neck and back. This calms the muscles and effectively addresses the pain that can be caused by the tight knots.

  1. Spinal accessory nerve block:

With spinal accessory nerve blocks, patients frequently note an improved range of movement in their head, neck and shoulders after this nerve block and analgesic to the spinal accessory nerve, which runs from the back of the head, down the neck and into the shoulder blades to control the trapezius and sternocleidomastoid neck muscles.

Damage, injury or impingement of this nerve can cause pain that is alleviated or minimized with a successful nerve block injection.

  1. Transcapular nerve block:

A transcapular nerve block is an injection with other medications to improve the pain caused by the transcapular (or suprascapular) nerve, which begins in the cervical spine and travels outwards, toward the shoulders. It innervates the trapezius, supraspinatus and infraspinatus muscles of the shoulders and back, and thus when blocked, therapeutic pain relief can be provided.

The vast number of different nerve blocks available indicates that many types of headaches and migraines can be effectively treated. If you are seeking a peripheral nerve block in Toronto as a solution to your chronic headaches, come visit our clinic for more information. We will be happy to discuss with you the most appropriate treatment using nerve blocks.

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Go Painless

Our team at Painless Medicine and Therapeutics focuses on improving our patient’s pain conditions.

Our goal and philosophy is to make the patient’s therapeutic experience as painless as possible by finding a therapeutic plan that best treats their symptoms and lifestyle. We truly believe in collaboration and working closely with patients so that they have control over their medication, and so that the treatment aligns with our clinic’s values.

In cases where chronic pain cannot be cured, but instead must be effectively managed, our team’s purpose is to limit the complications and to minimize the severity of the symptoms experienced by the patient. We wish to optimize our patients’ control over their pain so they feel enabled to be the best possible version of themselves and enjoy life again.

If you are suffering from a chronic pain condition, we highly suggest that you visit our clinic in Toronto to see what we can do for you.