There are many types of migraines, and many types of migraine treatments. It’s hard to know which one might be right for you, so it’s important to consider many options and talk to your doctor about them.
A greater occipital nerve block (GON) is an uncommon migraine treatment that isn’t recommended as a first-line treatment, but may help you if your current treatment isn’t working.
What Is GON?
GON is when anesthetics are used to deaden sensation in the greater occipital nerve.
The greater occipital nerve is one of a pair of nerves (on each side) that emerge from your spine between the first and second neck bones. Each greater occipital nerve threads up through the muscles on the back of your head and along your skull. It reaches almost to your forehead. It is responsible for carrying sensations from the back and top of your head.
Because many people have tenderness in the regions of the head served by these nerves along with their migraines, it has been suggested that they may play a role in causing some migraines.
Who Is GON for?
GON is sometimes recommended for people who:
- • Have not been getting good results from migraine drug treatments
- • Have excessive side effects with their migraine treatment
- • Have tenderness in the back or top of their head along with migraines
- • Don’t have chronic tension headaches
It’s worth noting that GON is still a relatively new procedure that doesn’t have fully established clinical guidelines. Different doctors may recommend it for people with slightly different indications based on their professional experience and research.
Is It Safe?
Because the procedure uses only an injection of a temporary anesthesia, it is considered very safe, reversible, and conservative treatment option.
Is It Effective?
As mentioned above, GON is still a relatively new procedure, and many scholarly reviews of the evidence call for more controlled studies to be conducted in the future, so the evidence is still preliminary. Here are some of the more important findings:
- • One study of GON on multiple headache types, including 54 migraine sufferers, showed that 46% of patients experienced either complete relief or partial relief (defined as at least 30% reduction in severity or frequency) of migraines, with a median partial relief time of 30 days.
- • A study comparing different GON formulations found that people saw a reduction of pain intensity of about 3 points on a 10-point scale for perhaps three days
- • An early study of 27 migraine patients showed that 85% of patients were responsive for up to six months. Responsiveness in this case was designated as a 50% reduction in Total Pain Index for a month.
With many variables between these studies, it’s hard to know how effective this procedure really is.
Do You Have Muscle Tension Headaches?
On the other hand, GON is not recommended for people with muscle tension headaches. Some studies indicated these patients may actually experience worsened pain from GON. If you experience this type of headache, you may benefit more from