Pain pathways in headache are relayed through important centres in the upper neck. These centres are affected by a set of muscles that, when malfunctioning, can generate headache. The principal of treatment is to rehabilitate these muscles for long term reduction of their contribution to a patient’s pattern of headaches. Injections are used to break cycles of pain to help sustained recovery of muscle function.
Specific sites chosen are individual to the needs of each patient after clinical examination. Locally acting steroid mixed with local anaesthetic is targeted at each area of pain to reduce local inflammation. The injections are uncomfortable - rather like injections of steroid for other routinely treated areas of pain in the body. The effect of the local anaesthetic is to reduce and abolish pain within about 20 seconds.
Releasing pain that is inhibiting muscle function may result in reduction or ablation of headache if present at the time of treatment, and improvement in restricted neck function. The local anaesthetic effect lasts about 45 minutes, but is useful as a marker for placement of the steroid which continues a slow acting course.
Significant complications from these injections are rare but may include, in common with any injection, local bruising or bleeding. In common with other steroid treatments, even at the low doses needed in local treatment, some patients might also experience:
Local pain at the injection sites may be experienced in the first few days, though headache is often diminished. More headaches may, however, be experienced in the second to third week, but after this the frequency and severity of headache impact should break up over a further period of time as muscle function stabilises.
Dr Valori, General Practitioner MB chB, is happy to see patients experiencing pain with Headache and Migraine arising from the neck area.
Dr Valori has treated patients with Migraine in Harley Street, at the London Independent Hospital and at the Norfolk & Norwich University Hospital.
Dr Valori is on the Council of the British Association for the Study of Headache (BASH) and on the Cervicogenic Headache International Study Group. He has presented at National and International conferences on headache. He is a regular contributor to the Oxford Annual Symposium on Headache.
If you would like to make an appointment to see Dr Valori, he will be happy to see both insured patients and patients that wish to pay for their own treatment. Initially you will first need to ask your GP or Consultant to send a letter of referral to Dr Valori at the Global Clinic, Norwich by fax to 01603 810880 or by post to:
The Global Clinic, Norwich
Please visit www.norfolkmigrainclinic.co.uk for further information.