Peled Migraine Surgery Blog

Information and knowledge about migraine relief surgery.

2 minutes reading time (406 words)

A Pain in the Neck!

Over the past few months I have seen quite a number of patients who’ve told me that they believe their migraines began not long after a motor vehicle accident. Many of them said they were initially told they suffered from “whiplash” by their treating physicians. These patients tried and subsequently failed several treatment modalities such as physical therapy and muscle relaxant medications.

Over the past few months I have seen quite a number of patients who’ve told me that they believe their migraines began not long after a motor vehicle accident. Many of them said they were initially told they suffered from “whiplash” by their treating physicians. These patients tried and subsequently failed several treatment modalities such as physical therapy and muscle relaxant medications. What’s interesting is that many of them have noted that they have sharp, stabbing pain in the back of the head on either side of the midline. Often this pain is worsened by pressure on the back of the head such as occurs when sleeping (i.e. the pillow sign) and many have noted that they often wake up with headaches or sleep sitting up to avoid them. So what do such scenarios have to do with occipital neuralgia?

In the vast majority of these patients, the culprit was a traction (i.e. stretch) injury of the greater occipital nerve(s), thus causing occipital neuralgia. As these nerves pass from the spinal cord to the back of the scalp where they provide sensation, they pass through or around several very strong and large muscles. Along the way, these nerves also traverse several tough connective tissue tunnels (think of the sinew in a cut of beef or chicken). During a motor vehicle accident in which the neck is jarred back and forth, these nerves can be kinked or stretched around these surrounding tissues thus causing scarring, nerve injury and ultimately pain. Fortunately, the treatment of occipital neuralgia secondary to a traction injury is much the same as that for treating chronic headaches. In fact, if you think about it, the symptom complexes are quite similar. After ruling out any bony or ligamentous injuries which is usually done at the time of the accident in the emergency room, diagnostic nerve blocks or Botox injections can be performed to determine which occipital nerves may have been injured. If successful, then a surgical procedure can be performed to hopefully provide the same degree of relief on a permanent basis.

Let's go to the numbers, shall we....
The Long & Winding Road
 

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Saturday, 17 November 2018

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