Chronic Headache and the Pain Clinic

Nerve block is the mainstay of therapy at pain clinics in Japan. The results of nerve blocks, namely the blocking of sensory pain pathways, vicious cycles of pain, sympathetic neural functions, and motor nerves are very useful in treating pain. If the same effects are to be obtained by drug administration, the concomitant use of many drugs with different actions is necessary, but even so, the effects would not be as good as those of nerve blocks. The headaches that are dealt with at pain clinics are mostly chronic, recurrent headaches such as migraines, cluster headaches, tension-type headaches, and posttraumatic symptomatic headaches. Headaches that originate in the cervical spine, although they are acute in nature, also respond well to nerve blocks. Stellate ganglion block, gasserian ganglion block, trigeminal nerve branch block, and occipital nerve block are the major nerve blocks that are used for the treatment of headaches. The concomitant use of general drugs as well as oriental therapies is also common.