26.04.2014

Treatment for occipital nerve headache

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Location and intensity of the pain: The use of a body pain diagram may be helpful to understand the pain distribution and characteristics, and may be helpful in directing further evaluation. Neurologic symptoms: Examine the patient for the presence and location of neurologic symptoms, like numbness or tingling, as well as the duration.
Do you recommend using technology (smartphone apps, Fitbits, etc) to help your patients become more active? Vertical Health Media, LLC does not, by publication of the advertisements contained herein, express endorsement or verify the accuracy and effectiveness of the products and claims contained therein. Practical Pain Management is sent without charge 10 times per year to pain management clinicians in the US. Radiofrequency ablation is a technique used for patients who have had one or more affected nerves confirmed as a chronic source of pain, and who have had a certain percentage of pain relief provided (over 60%) when the afflicted nerves are blocked. There are a variety of pain relief applications available to patients who are eligible to receive a radiofrequency ablation treatment. Radiofrequency ablation has also been shown to be an effective means of treatment for the sacroiliac joint and the sub-occipital nerve. Ablation is performed as an outpatient technique, with many physicians opting to use full intravenous sedation for patients to reduce the risk of procedural error. After the probe has been positioned where the physician determines most effective, the end of the probe will be stimulated with very minor heat. Following the trial stimulation phase, the ablation probes will be heated in a carefully controlled manner to destroy the pain-causing nerve endings to provide symptomatic relief to the patient.
While many of the typical therapeutic methods offered to patients deal with relief in terms of months, radiofrequency ablation offers patients multiple years of relief. New Mexico Pain offers the top pain clinics in Albuquerque, providing the best Board Certified doctors in the state utilizing both medication management and interventional procedures. Acupuncture is a form of therapy that was developed by the Chinese thousands of years ago, and has  been in use in China and many other countries since. Sometimes the acupuncturist will use other methods to relieve pain or treat a particular problem area on the body. Acupuncture is thought to work by promoting relaxation and allowing chemicals and blood within the body to flow properly.
Using acupuncture as a treatment for CRPS works differently on each patient, and may not display favorable results in all cases.
After a typical session of acupuncture using needles, there is some bleeding when the needles are removed, and often some bruising as well. This article reviews the anatomy, common causes, as well as practical approaches to the management of neck pain.By Gerard A. The C1-C2 (atlantoaxial) joint forms the upper cervical segment, which allows for 50% of all cervical rotation.
These injuries can occur from an extension, lateral bending, or rotation mechanism, which close the neural foramen and result in ipsilateral nerve root injury. If this is related to a motor vehicle accident, then the history should include where the patient was in the vehicle, whether they were wearing a seat-belt restraint, and whether they require emergency transportation and assessment at an emergency department. A forward head and rounded shoulder posture are common in patients presenting with myofascial neck pain. The prevalence of neck pain in the world population: a systematic critical review of the literature.
Guidelines for the management of acute whiplash-associated disorders for health professionals. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: executive summary.
Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association. Validity of clinical tests in the diagnosis of root compression in cervical disc disease. Normal morphology, age-related changes and abnormal findings of the cervical spine—part II: magnetic resonance imaging of over 1,200 asymptomatic subjects. High-resolution CT scanning in the evaluation of cervical spine fractures: comparison with plain film examinations.


Cervical spine imaging in patients with trauma: determination of fracture risk to optimize use. The value of neurophysiological and imaging studies in predicting outcome in the surgical treatment of cervical radiculopathy.
Needle EMG has a lower false positive rate than MRI in asymptomatic older adults being evaluated for lumbar spinal stenosis. The efficacy of conservative treatment in patients with whiplash injury: a systematic review of clinical trials. Rehabilitation of neck-shoulder pain in women industrial workers: a randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training.
Comparative study of high bio-availability glaphenine and paracetamol in cervical and lumbar arthrosis. Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study. Effectiveness and safety of topical capsaicin cream in the treatment of chronic soft tissue pain. The efficacy and safety of eperisone in patients with cervical spondylosis: results of a randomized, double-blind, placebo-controlled trial.
Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens. Controlled-release oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy. Long-term results of cervical epidural steroid injection with and without morphine in chronic cervical radicular pain. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain: a randomized, controlled trial. Manipulation of the cervical spine: a systematic review of case reports of serious adverse events, 1995-2001.
Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults. Radiofrequency denervation for neck and back pain: a systematic review of randomized controlled trials.
Clinical outcomes of cervical radiculopathy following epidural steroid injection: a prospective study with follow-up for more than 2 years.
Long-term effect of pulsed radiofrequency on chronic cervical radicular pain refractory to repeated transforaminal epidural steroid injections.
Vertical Health Media, LLC disclaims any liability for damages resulting from the use of any product advertised herein and suggests that readers fully investigate the products and claims prior to purchasing.
Ablation is the careful, controlled destruction of the nerve ending through heat to permanently stop the transmission of pain signals from the nerve to the brain. The most commonly treated source of pain in patients is chronic facet arthritis, which accounts for nearly 20% of all lumbar pain in patients. Patients suffering from hemicrania continua (a unique unilateral headache) are also potentially able to obtain relief with radiofrequency ablation to the sub-occipital nerve according to a case study (Radiofrequency ablation of the supra-orbital nerve in the treatment algorithm of hemicrania continua, 2012). For patients who choose not to receive sedation, a strong painkiller will be given in addition to the application of local anesthetic to the injection site.
If the patient experiences pain during this stimulation, the probe has been placed too close to the nerve root and must be re-positioned.
The duration of the procedure will vary on a patient-to-patient basis, as the number of nerve endings present in the target area can be different for each individual (Radiofrequency treatment has a beneficial role in reducing low back pain due to facet syndrome in octogenarians or older.,2013). The average duration of relief is between one and two years, with symptoms only returning as the afflicted nerve ends begin to re-grow. During a session of acupuncture, the patient will lie very still on a massage or examination table. CRPS patients that have been treating using acupuncture have often reported relief of pain that is immediate, but temporary, lasting only one or two hours. Acupuncture also works only on the physical aspect of RSD, not on the neurological issues at the root of the disease.
Acupuncture is a highly invasive form of therapy, and is usually only considered when more traditional methods have failed to show acceptable results.


Several guidelines on the management of neck pain have been published.3-6 However, there remains no definitive consensus on this topic. Conversely, a traction injury can occur with a sudden flexion or extension, coupled with lateral bending away from the affected nerve root. Performed correctly, radiofrequency ablation is painless for the patient and is able to provide long-lasting relief. According to a study (Efficacy of combined treatment with medial branch radiofrequency neurotomy and steroid block in lumbar facet joint arthropathy, 2012) into a combined radiofrequency ablation and medical branch block, patients were able to achieve substantial long-term relief.
Ablation is performed by inserting a specialty ablation needle until it is in very close proximity to the afflicted nerve. After nerve endings have began to grow back, ablation can be repeated as necessary to maintain relief.
The largest risk is that a nerve may be accidentally damaged during stimulation despite the prior trial stimulations.
In the most common form of acupuncture, the apuncturist will place very thin needles through the skin at certain points on the body, called acupoints.
When using this method, the apuncturist will place a glass cup on the skin, usually on the patient’s back. This can feel like lack of progress, but the goal of the acupuncture is not only this temporary relief.
Although acute neck pain generally resolves with conservative treatment, an algorithmic approach should be applied to ensure a full assessment of this complaint. Below the C2-C3 level, lateral bending of the cervical spine is coupled with rotation in the same direction. Additionally, cervical disc herniations can occur with a sudden load with the neck in either flexion or extension.
Patients suffering from chronic discogenic pain may also be able to obtain long term pain relief (A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain, 2004). This process will be repeated until a patient does not react to the stimulation, ensuring that the probe has been positioned correctly where it will not inadvertently damage a nerve root. However, RSD cases are highly individualized and in many cases conventional therapies and medications show little or no results.
The cup will either be filled with hot smoke, or be attached to a suction gun that pulls the air out of the cup.
After a few sessions, many patients reported increased mobility of limbs affected by CRPS or RSD. The fact that acupuncture is not a traditional form of treatment for CRPS can also be a drawback, as most insurance companies will not approve payment for alternative forms of treatment.
In rare cases, there have been reports of pierced organs, although this could have been avoided with proper physician training of the procedure.
If the therapies that have been tested are not alleviating any of the symptoms of CRPS, physicians and patients may turn to alternative forms of treatment, such as acupuncture.
On the lateral aspect of the vertebral bodies are sharply defined margins, which articulate with the facet above.
The discs are composed of an outer annular fibrosis and an inner nucleus pulposus and serve as force dissipators, transmitting compressive loads throughout a range of motion. The intervertebral discs are thicker anteriorly and therefore contribute to normal cervical lordosis.
The neural foramen is bordered anteromedially by the uncovertebral joints, posterolaterally by facet joints, superiorly by the pedicle of the vertebra above, and inferiorly by the pedicle of the lower vertebra. Medially, the foramina are formed by the edge of the end plates and the intervertebral discs.
The nerve roots exit above their correspondingly numbered vertebral body from C2-C7; C1 exits between the occiput and atlas, and C8 exits below the C7 vertebral body. Degenerative changes of the structures that form the foramina can cause nerve root compression.



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