Headache

When should headaches be evaluated by a specialist?

Occasional headaches are nearly universal, but headaches that occur 15 or more days per month, fail to respond to usual medications, follow a neck injury, or consistently start at the base of the skull deserve specialty evaluation. Sudden "worst headache of your life," headache with fever and stiff neck, or headache with neurologic changes are emergencies — call 911.

What types of headache respond to interventional treatment?

Two patterns respond particularly well. Occipital neuralgia — irritation of the occipital nerves at the back of the head — causes shooting or electric pain from the skull base toward the scalp. Cervicogenic headache is pain referred to the head from arthritic joints or other structures in the upper neck. Both are frequently mistaken for migraine and both can be confirmed with diagnostic nerve blocks.

How are these headaches treated?

Occipital nerve blocks serve as both diagnosis and treatment, often providing weeks to months of relief. For cervicogenic headache, blocks and radiofrequency ablation of the upper cervical facet nerves address the true source in the neck. Dr. Eaddy coordinates care with your neurologist or primary physician so interventional treatment complements — rather than replaces — your overall headache management.