# Peripheral nerve blocks for primary and secondary headache disorders: review of current evidence and a practical approach

**Authors:** Sophie McGough, Linford Fernandes, Luis Idrovo

PMC · DOI: 10.22514/jofph.2026.002 · 2026-01-12

## TL;DR

This paper reviews the use of peripheral nerve blocks for treating various headache disorders and provides practical guidelines for their application.

## Contribution

The paper updates the current evidence and offers a practical approach for using peripheral nerve blocks in headache treatment.

## Key findings

- Peripheral nerve blocks are widely used for treating primary and secondary headache disorders.
- PNBs have demonstrated safety, tolerability, and efficacy in clinical practice.
- The paper outlines indications, techniques, and potential pitfalls of common PNB procedures.

## Abstract

Headache is prevalent, disabling, and a frequent neurological referral in the 
healthcare system. Clinic-based procedures have evolved in recent years to play 
an important role in headache medicine, with growing evidence on the safety, 
tolerability and efficacy of peripheral nerve blocks (PNBs). Despite novel 
headache therapies, PNBs are still widely used in headache services to treat 
primary and secondary headache disorders, including cluster headache and other 
trigemino-autonomic cephalalgias, migraine, occipital neuralgia, and other less 
frequent headache disorders. We aim to provide an update of the current evidence 
and a practical approach for delivering the most common PNBs used in clinical 
practice. We aim to describe PNBs indications, contraindications, injection 
locations and techniques, drug constituents, and potential pitfalls.

## Linked entities

- **Diseases:** cluster headache (MONDO:0043537), migraine (MONDO:0005277)

## Full-text entities

- **Diseases:** Nerve block (MESH:D006327), avascular necrosis of  the hip (MESH:D010020), nerve injury (MESH:D000080902), pain (MESH:D010146), allergic reaction (MESH:D004342), GON (MESH:D012784), paresthesias (MESH:D010292), acute migraine  aura (MESH:D020325), neurologic  depression (MESH:D003866), post (MESH:D000094025), myotoxicity (MESH:D000081030), intracranial hypotension (MESH:D019585), dizziness (MESH:D004244), numbness (MESH:D006987), HC (MESH:D006261), nausea (MESH:D009325), alopecia (MESH:D000505), LON (MESH:D006259), diabetes (MESH:D003920), CH (MESH:D003027), LAST (MESH:D004828), trigeminal nerve blocks (MESH:D020433), coma (MESH:D003128), post dural puncture headaches (MESH:D051299), vasovagal episodes (MESH:D019462), agitation (MESH:D011595), lipoatrophy (MESH:C535905), respiratory arrest (MESH:D012131), candidiasis (MESH:D002177), seizures (MESH:D012640), Secondary Headache disorders (MESH:D051271), PNBs (MESH:D010523), subarachnoid haemorrhage (MESH:D013345), toxicity (MESH:D064420), occipital neuralgia (MESH:D009437), bleeding (MESH:D006470), Cushing's syndrome (MESH:D003480), atrophy (MESH:D001284), cranial nerve  block (MESH:D003389), infection (MESH:D007239), nerve (MESH:C537568), skull defect (MESH:D012888), Cushing's disease (MESH:D047748), presyncope (MESH:D013575), headache  disorders (MESH:D020773), Primary  headache disorders (MESH:D051270), Migraine (MESH:D008881), hypopigmentation (MESH:D017496), drop of blood pressure (MESH:D006973), PH (MESH:D051302), cervicogenic  headache (MESH:D051298), tinnitus (MESH:D014012), hyperglycemia (MESH:D006943), thrombotic (MESH:D013927)
- **Chemicals:** acetaminophen (MESH:D000082), lamotrigine (MESH:D000077213), Indomethacin (MESH:D007213), topiramate (MESH:D000077236), caffeine (MESH:D002110), Methylprednisolone acetate (MESH:D000077555), steroid (MESH:D013256), triamcinolone (MESH:D014221), GON (-), sodium (MESH:D012964), metoclopramide (MESH:D008787), dexamethasone (MESH:D003907), triptans (MESH:D014363), Lidocaine (MESH:D008012), methylprednisolone (MESH:D008775), verapamil (MESH:D014700), Bupivacaine (MESH:D002045)
- **Species:** Homo sapiens (human, species) [taxon 9606]

---
Source: https://tomesphere.com/paper/PMC12853162