Migraines can be hard to treat. Part of the problem is that “migraine” is a blanket label used to describe many related, but fundamentally different, conditions. If you are going to get relief from your migraine, you have to be prepared to consider and try many different treatments. Greater occipital nerve block (which, like TMJ, has a couple of different acronyms, either GON or GONB–we’ll use GON) is a treatment that may help some people with migraines that don’t respond to treatment or for people who have negative side effects.
What Is GON?
GON is a nonsurgical, minimally invasive procedure to reduce migraine pain. It uses injections of anesthetic, and, sometimes, steroids, into the greater occipital nerves, to deaden them and potentially cut off pain signals responsible for your migraine.
The greater occipital nerve emerges from your spine between the first and second vertebrae (the top two bones in your neck). There are two of them, one on each side, and they travel along your scalp almost to your forehead. These nerves carry pain signals mostly from the back and top of your head, but sometimes pain that you think is in your forehead is actually being carried by these nerves (because of referred pain).
It’s long been known that people with migraines often feel pain or tenderness at the top or back of their heads, which are served by the greater occipital nerves, which is why people came up with the idea that blocking them might lead to migraine relief.
Who Is GON for?
GON is still a relatively new procedure, and it doesn’t have generally accepted standardized treatment guidelines. However, GON is most commonly recommended for people when:
- Migraine drug treatment gives poor results
- Side effects mean drug treatment has minimal benefit
- Tenderness in the back or top of the head accompanies migraine
Sometimes GON is recommended for other types of headaches, such as cluster headaches. Doctors’ recommendations vary based on their experience and research. Talk to your doctor about the treatment and listen carefully to their recommendations.
Is It Safe?
One of the biggest benefits of GON is its safety. The procedure uses only an injection of temporarily-acting anesthetic and steroids. It’s fully reversible with few risks.
Is It Effective?
This is the main disadvantage of GON. Because it’s so new, there’s not a lot of good data on how well it works. The largest comprehensive reviews call for call for more controlled studies to be conducted in the future. Here’s a summary of some of the promising findings:
- When used on multiple headache types, including migraine, it seemed to be fairly effective. Among migraine sufferers, 46% experienced either complete relief or partial relief of migraines. Relief lasted anywhere from one day to 90 days, with median relief of about 30 days.
- One study trying to find the optimal anesthetic-steroid formulation for GON found that no matter what formulation was used, people saw about a 3-point reduction in their pain for about 3 days.
- One of the first and most optimistic studies on GON showed that up to 85% of migraine sufferers were responsive (defined as seeing a 50% reduction in Total Pain Index) for up to six months.
Needless to say, the data is all over the map. You could see results that range from a slight reduction to complete elimination and that last for anywhere from one day to six months.
What about Muscle Tension Headaches?
Among the types of headaches considered for treatment with GON are muscle tension headaches. However, this type of headaches responded very unfavorably to GON. In one study, 15 sufferers were treated with GON. Eleven saw no results, and four saw their headache worsen.
However, one treatment that can be very effective on both muscle tension headaches and migraines is TMJ treatment. If you want to learn more about this option and whether TMJ treatment can help your migraines, please call (303) 691-0267 at the TMJ Therapy & Sleep Center of Colorado in Denver today.
