You have tried the medications. You have adjusted your diet, tracked your triggers, and avoided everything on the list your neurologist gave you. The migraines still come. When that is where you are, nerve blocks for migraine headaches are often the next conversation worth having.
Nerve blocks work differently than preventive medications. They target the specific nerve pathways that are generating or transmitting your migraine pain, rather than trying to alter brain chemistry systemically. For patients who have not found adequate relief through oral medications, nerve blocks can provide meaningful and sometimes rapid reduction in migraine frequency and intensity.
Dr. Nidal Elbaridi at Loop Medical Center performs nerve blocks for migraine headaches at both Chicago locations. This article explains how they work, which types are used, what to expect from a session, and how nerve blocks compare to other treatments like Botox.
What Are Nerve Blocks for Migraine Headaches?
A nerve block for migraine headaches is an injection of a local anesthetic, sometimes combined with a corticosteroid, delivered to a specific nerve or nerve cluster that contributes to migraine pain. The injection temporarily interrupts pain signal transmission along that nerve pathway, reducing or eliminating migraine symptoms. Relief can begin within minutes to hours of the injection and may last from several weeks to several months depending on the nerve targeted and the patient’s individual response.
Nerve blocks are both diagnostic and therapeutic. They can confirm that a specific nerve is involved in your migraine pattern, and they can provide sustained relief when the correct nerve is identified and treated.
Types of Nerve Blocks for Migraines
Occipital Nerve Block
The occipital nerve block is the most commonly performed nerve block for migraine headaches. The occipital nerves run from the base of the skull upward along the back of the head. When these nerves become irritated or inflamed, they can trigger migraines and a related condition called occipital neuralgia, which produces sharp, shooting pain from the neck to the scalp.
Dr. Elbaridi injects a local anesthetic around the greater and lesser occipital nerves at the base of the skull. The procedure takes a few minutes in the office and requires no sedation. Most patients experience relief within 15 to 30 minutes. The occipital nerve block is effective for migraines, cluster headaches, cervicogenic headaches, and occipital neuralgia.
Trigeminal Nerve Block
The trigeminal nerve is the largest cranial nerve and is responsible for sensation across most of the face. It plays a central role in many types of facial pain and headache, including migraines that present with significant facial involvement, trigeminal neuralgia, and TMJ-related headaches.
A trigeminal nerve block, sometimes performed as a gasserian ganglion block targeting the main ganglion of the trigeminal nerve, can reduce or eliminate pain in patients whose migraines involve significant facial or jaw pain, pain around the eye or cheek, or electric-shock sensations triggered by everyday activities like chewing, speaking, or brushing teeth.
Sphenopalatine Ganglion Block
The sphenopalatine ganglion (SPG) is a nerve cluster located behind the nose. It is closely connected to the trigeminal nerve and plays a role in migraine pain, cluster headaches, and facial pain syndromes. An SPG block is delivered through a thin catheter passed through the nasal passage, making it a minimally invasive option with no needles at the injection site. It is particularly useful for cluster headaches and migraines with significant pressure behind the eyes or in the sinus region.
TMJ-Related Nerve Block
Temporomandibular joint dysfunction is a frequently overlooked contributor to chronic headaches. The jaw joints and surrounding muscles can refer pain upward into the temples, behind the eyes, and around the skull in patterns that closely mimic migraines. When TMJ dysfunction is suspected as a driver of headache, a targeted nerve block into the joint under ultrasound guidance both confirms the diagnosis and provides relief. If TMJ is confirmed as the source, additional treatment options including radiofrequency ablation or regenerative injections may be appropriate.
Nerve Block vs Botox for Migraines: Which Is Right for You?
Both nerve blocks and Botox are effective, evidence-based treatments for migraine headaches. They work through different mechanisms and are appropriate for different patient profiles.
Nerve blocks use a local anesthetic to interrupt pain signals along a specific nerve pathway. They work quickly, often within hours, and are particularly effective for patients with identifiable nerve involvement, those seeking fast relief between preventive treatments, or patients who need a diagnostic evaluation of which nerve is contributing to their pain. The duration of relief typically ranges from a few weeks to several months.
Botox (onabotulinumtoxinA) is FDA-approved for chronic migraines, defined as 15 or more headache days per month. Botox is injected at 31 to 39 sites across the head and neck every 12 weeks and works by blocking the release of neurotransmitters involved in pain signaling. It typically requires two to three treatment cycles before maximum benefit is achieved. Botox is less effective for patients with fewer than 15 headache days per month.
Some patients benefit from both. A nerve block can provide fast relief while Botox builds up to its full preventive effect over several months. Dr. Elbaridi will evaluate your migraine frequency, pattern, and history to recommend the most appropriate approach, or a combination of both.
How Long Does a Nerve Block Last for Migraines?
Duration varies by the type of nerve block, the medication used, and the individual patient. Most patients can expect the following:
- Occipital nerve block: relief typically lasts 4 to 12 weeks, with some patients reporting longer benefit after multiple treatments
- Trigeminal or gasserian ganglion block: duration varies based on the specific injection and whether corticosteroid is included, generally 4 to 8 weeks
- Sphenopalatine ganglion block: relief may last from a few days to several weeks; repeated treatments can extend the benefit
Nerve blocks can also have a cumulative effect. Some patients find that with repeated treatments, the intervals between injections lengthen and the overall migraine burden decreases.
Migraine Nerve Block Side Effects
Nerve blocks for migraine headaches are generally well tolerated. Side effects are typically mild and temporary.
Common side effects include:
- Temporary soreness or bruising at the injection site
- Brief stinging or burning during the injection
- Temporary numbness or tingling in the treated area
- Lightheadedness immediately following the procedure
Serious complications are rare when the procedure is performed by an experienced interventional pain physician using proper technique and imaging guidance where appropriate. Dr. Elbaridi performs all nerve block procedures himself and will review your medical history, current medications, and any contraindications before your procedure.
What to Expect at Loop Medical Center
A nerve block for migraine headaches at Loop Medical Center is an in-office procedure. No sedation or hospital stay is required.
At your initial visit, Dr. Elbaridi will take a full history of your headache pattern, review any prior treatments and imaging, and perform a physical examination. He will identify which nerve pathways are most likely contributing to your migraines and recommend the appropriate type of nerve block.
The injection itself takes a few minutes. Depending on the type of block, you may feel mild pressure or temporary stinging at the site. Most patients leave the office the same day and return to normal activities shortly after. You will be monitored briefly following the procedure before discharge.
Dr. Elbaridi will schedule a follow-up to evaluate your response and determine whether additional treatments are needed.
When to See Dr. Elbaridi for Migraines
Consider scheduling an evaluation if:
- You have migraines that are not adequately controlled by oral medications
- You experience 4 or more migraine days per month
- You have tried multiple preventive medications without sufficient improvement
- Your migraines involve significant neck pain, base-of-skull pain, or facial pain
- You are looking for a faster-acting option while Botox builds to full effect
- You have been told you are not a Botox candidate because your headaches are fewer than 15 days per month but are still significantly impactful
Loop Medical Center accepts most PPO plans, Medicare Advantage, HMO plans, Workers Compensation, and Personal Injury cases. Same-week appointments available at both Chicago locations.
Frequently Asked Questions
Can nerve blocks help with migraines?
Yes. Nerve blocks for migraine headaches are a well-established interventional treatment used when medications alone are not providing adequate control. By targeting the specific nerve pathways involved in migraine pain, nerve blocks can reduce both the frequency and severity of attacks. They are particularly effective for migraines with an identifiable nerve component, such as those involving the occipital, trigeminal, or sphenopalatine nerves.
What is the best nerve block for migraines?
The most effective nerve block depends on your specific migraine pattern. The occipital nerve block is the most commonly used and is effective for migraines that involve the back of the head, base of the skull, or neck. The sphenopalatine ganglion block is often preferred for cluster headaches and migraines with pressure behind the eyes. The trigeminal nerve block is used when facial pain or jaw involvement is significant. Dr. Elbaridi will evaluate your headache pattern to determine which approach fits your case.
How long does a nerve block last for migraines?
Most patients experience relief lasting 4 to 12 weeks from an occipital nerve block. Other types of nerve blocks may provide shorter or longer relief depending on the nerve treated and the medications used. With repeated treatments, some patients find that intervals between injections lengthen over time. Dr. Elbaridi will monitor your response and schedule follow-up treatments accordingly.
What are the side effects of a nerve block for migraines?
Side effects are generally mild and temporary. The most common include brief soreness or bruising at the injection site, temporary numbness or tingling in the treated area, and occasional lightheadedness immediately after the procedure. Serious complications are uncommon when the procedure is performed by an experienced physician. Dr. Elbaridi will review your full medical history before the procedure to ensure it is safe for you.
How much does a nerve block for migraines cost?
Nerve blocks for migraine headaches are covered by most PPO insurance plans, Medicare Advantage, and many HMO plans when medically necessary criteria are met. Out-of-pocket cost depends on your specific plan and whether prior authorization is required. Loop Medical Center will verify your benefits before your appointment so you know what to expect. Call us at (312) 414-1088 for a benefits check.
What is the difference between a nerve block and Botox for migraines?
A nerve block uses a local anesthetic injected near a specific nerve to interrupt pain signaling. It works quickly, often within hours, and is appropriate for a wide range of migraine patients. Botox is FDA-approved for chronic migraines (15 or more days per month), works by blocking neurotransmitter release, and is injected at multiple sites across the head and neck every 12 weeks. Botox typically requires two to three treatment cycles to reach full effect. Nerve blocks and Botox are not mutually exclusive and are sometimes used together.
Ready to Talk About Your Migraines?
If your migraines are not responding to medication or you want to explore a more targeted approach, call us. Dr. Elbaridi will review your headache history, examine the contributing nerve pathways, and recommend the most effective treatment for your specific pattern.
Call or text: (312) 414-1088
South Loop: 1921 S Michigan Ave, Chicago, IL 60616
Streeterville: 432 E Grand Ave, Suite A, Chicago, IL 60611
Medically reviewed by Dr. Nidal Elbaridi, Interventional Pain Management Physician, Loop Medical Center, Chicago. Last updated: July 2026.