Purpose of the Review

To provide an overview of current interventional pain management techniques for primary headaches with a focus on peripheral nerve stimulation and nerve blocks.

Recent Findings

Despite a plethora of treatment modalities, some forms of headaches remain intractable to conservative therapies. Interventional pain modalities have found a niche in treating headaches. Individuals resistant to common regimens, intolerant to pharmaceutical agents, or those with co-morbid factors that cause interactions with their therapies are some instances where interventions could be considered in the therapeutic algorithm. In this review, we will discuss these techniques including peripheral nerve stimulation, third occipital nerve block (TON), lesser occipital nerve block (LON), greater occipital nerve block (GON), sphenopalatine block (SPG), radiofrequency ablation (RFA), and cervical epidural steroid injections (CESI).

Summary

Physicians have used several interventional techniques to treat primary headaches. While many can be treated pharmacologically, those who continue to suffer from refractory or severe headaches may see tremendous benefit from a range of more invasive treatments which focus on directly inhibiting the painful nerves. While there is a plethora of evidence suggesting these methods are effective and possibly durable interventions, there is still a need for large, prospective, randomized trials to clearly demonstrate their efficacy.

中文翻译：

---

慢性头痛：头痛治疗中介入治疗策略的回顾。

审查目的

提供当前针对原发性头痛的介入性疼痛管理技术的概述，重点是周围神经刺激和神经阻滞。

最近的发现

尽管有许多治疗方法，但某些形式的头痛对于保守疗法仍然难以解决。介入式疼痛治疗方法在治疗头痛方面已经找到了一个利基市场。在某些情况下，可以对治疗方案中的干预措施加以考虑，这些患者对通用方案具有抗药性，对药物制剂不耐受，或者具有导致其疗法相互作用的共病因素的患者。在这篇综述中，我们将讨论这些技术，包括周围神经刺激，第三枕神经阻滞（TON），小枕神经阻滞（LON），大枕神经阻滞（GON），蝶ala阻滞（SPG），射频消融（RFA），和颈硬膜外类固醇注射（CESI）。

概要

医师已经使用了几种介入技术来治疗原发性头痛。尽管许多药物可以通过药物治疗，但那些继续患有难治性或严重头痛的人可能会从一系列旨在直接抑制疼痛神经的更具侵入性的治疗中受益匪浅。尽管有大量证据表明这些方法是有效的并且可能是持久的干预措施，但仍需要进行大型，前瞻性，随机试验以明确证明其有效性。