Infiltrations relieve pain in headaches and migraines

The specialist in Neurology and coordinator of the Headache Unit Quirónsalud San José Hospital, Lucia Vidorretaexplained that, although pharmacological treatments continue to be the basis for headache and migrainein recent years they have gained relevance infiltration techniques Minimally invasive that act directly on the pain mechanisms.

These techniques, he specifies, not only offer symptomatic relief, but in many cases contribute to reduce the frequency and intensity of seizuresespecially in patients refractory to conventional treatment. According to the expert, its proper use requires precise knowledge of the anatomy, the pathophysiology of pain and the available scientific evidence.

At this point, he has given as an example the anesthetic pericranial nerve blockswhich consist of the infiltration of local anesthetics, sometimes combined with corticosteroids, on nerves involved in the transmission of pain, such as the greater occipital nerve or the supraorbital nerve.

The specialist indicates that these blockages have proven useful in chronic migraineboth in prevention and treatment, in cluster headachein the cervicogenic headache and in the neuralgia of the terminal branches of the trigeminal nerve.

“In cluster headaches, for example, infiltration with anesthetic and corticosteroid can provide pain-free periods of several days or weeks,” indicated the expert, who added that their main advantage is that they are techniques “fast, secure and repeatablealthough they require individualization according to the profile of each patient.

On the other hand, there are the infiltrations in tension headache and myofascial syndrome. In many patients, especially with tension headaches, the origin of the pain is related to myofascial trigger points in the cervical and pericranial muscles. “In these cases, dry needling, especially when performed under ultrasound guidance, allows accurately identify the trigger point, reduce muscle contracture and reduce peripheral sensitization,” explains Vidorreta.

This approach, he assures, is especially useful in patients with a cervical component or with persistent pain despite pharmacological treatment. The use of ultrasound provides safety and precision, facilitating the personalization of treatment.

After this, the expert has stressed that Cluster headache is one of the most disabling forms of cranial pain; In this context, blocks with local anesthetic and corticosteroid, especially on the occipital nerve, have proven to be an effective tool as a temporary or bridging treatment.

“The corticosteroid provides a prolonged anti-inflammatory effect, which can reduce the frequency of attacks and/or shorten the active periods of the disease. Although the response is variable, many patients experience significant improvement in a few days,” he stated.

Other interventional techniques

In cases of patients with refractory headaches, additional techniques can be used that act by modulating the transmission of pain at a peripheral and central level: among them, radio frequency on peripheral nerves and the blockade of the sphenopalatine ganglion (transnasal route).

“Infiltration techniques have transformed the approach to headachesoffering effective, safe and personalized alternatives for patients who do not respond adequately to conventional treatments. They allow us to act directly on the mechanisms of pain, reducing both its intensity and its frequency,” highlights Vidorreta.

The specialist clarifies that its correct application requires a thorough neurological assessment and precise technical execution. In this context, the neurologist not only treats pain, but actively intervenes in its modulation, opening new therapeutic avenues that significantly improve the quality of life of patients. In Vidorreta’s words, “you can live without pain.”