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GON Block

Migraines are a common neurological disorder that can have a challenging treatment regime. Oral medications have been deemed successful in alleviating symptoms, but many people still struggle to find complete relief. Peripheral nerve block procedures have been introduced to treat and prevent future migraine attacks.

GON Block

The GON block works on the trigeminovascular system – the system vastly responsible for migraines. Multiple studies have demonstrated the short-term benefits of GON block, highlighting its potential to effectively reduce pain intensity and headache days in those who struggle with migraines. Most people see the effect for a couple of weeks, whereas some benefit from its properties for a more extended period.

The GON block is an injection containing a small dose of Depo-Medrone – a combination of local anaesthetic and a steroid – injected around the greater occipital nerve, which travels up each side of the back of the head. It works by reducing or blocking the signals sent by the greater occipital nerve, which can significantly improve symptoms of chronic headaches and migraines.

At the Royal Wharf Clinic here in London, we offer specialist assessment and treatment of migraines and their associated symptoms. Our process involves a comprehensive evaluation followed by a simple outpatient injection performed by one of our registered doctors. If you are one of many unfortunate sufferers of migraines which are rarely relieved by the administration of oral medication or a change of lifestyle, then give us a call to find out more about how our GON block migraine treatment works and how we can help.

Our doctors here at the Royal Wharf Clinic in London have been trained to administer a greater occipital nerve (GON) block for migraine treatment.

AT A GLANCE

BENEFITS

Reduce the frequency of migraine attacks
Reduce the severity of migraine attacks
Long-term relief
Can treat chronic headaches
Little potential for drug interactions

NEED TO KNOW

The GON block procedure involves administering an injection into the greater and lesser occipital nerves found in the sides of the back of your head. It is primarily used for the treatment of migraines but can be used to relieve chronic headaches associated with injuries such as whiplash. Some of the most important things you should take into consideration prior to your procedure are listed below: What you can expect during the procedure - you’ll be asked to lie face down on a table before the area on your neck is cleaned. Your doctor will then assess your occipital nerves by running their fingers across the back of your head. A topical anaesthetic will be used to numb the treatment site before a fine needle is carefully injected. An ultrasound device may be used to help guide the needle to a precise location. Some people may find that this procedure stings a little, but the sensation only lasts a few minutes. Once complete, we’ll monitor you for around 15 minutes to ensure you’re okay before you can go home. Length of pain relief varies - the steroids injected may take a couple of days to take full effect; however, pain relief can be felt in around 15-30 minutes. The anaesthetic will wear off within 4 hours, after which your regular levels of pain will return. The steroids will start to work within the first couple of days. The amount of time that the GON block works varies from person to person. Most people report 3-4 weeks of pain relief, with some having benefits for several months.

RECOVERY

Most people can go home 15-20 minutes after their treatment. You may experience some dizziness, nausea, or pain for a short while after your injection, which is entirely normal. Some people can feel the effects of the nerve block within the first 15-30 minutes, whereas for others, it may be a couple of days. The injections should last for 4-12 weeks, depending on how your body has reacted to the nerve block. It is common to receive 3-4 injections per year to maintain the pain-relieving effect of the GON block.

A consultation with a member of our staff is essential in allowing us to determine your eligibility for GON block treatment. This confidential consultation will be carried out by one of our consultants. We will ask you about your current symptoms, the medications and lifestyle interventions you have already tried, and your current medical history.

We will go through with you in detail the different aspects of the procedure and give you more information regarding the treatment. You can use this opportunity to raise any queries or concerns you may have regarding the treatment.

If you’re happy to proceed, we’ll ask you to register a profile using our HIPAA and GDPR-approved system, sign a consent form, and provide us with supplementary documents as specified by our team. Once complete, we’ll try our best to book you in for an appointment at a date and time most convenient for you.
Greater occipital nerve blocks are a generally well-tolerated, low-risk procedure. However, like most other medical procedures, there are some risks. Most side effects are considered mild and transient, and include:

Injection site tenderness – one of the most common side effects of GON block is injection site tenderness. Some people may feel slight pain, irritation, redness, or bruising. This should resolve within a couple of hours.
Syncope – some people report dizziness after the injection. This should resolve relatively quickly. We’ll ask you to wait in the clinic until your symptoms resolve before you can go home.

Worsening headaches – the treatment might not work for everybody, and for a small percentage of people, the headaches may worsen for a few days before they start getting better.
Nerve damage – some nerve damage may occur due to the nature of injections. We’ll keep an eye on you after treatment to ensure no associated symptoms of nerve damage.
Hair loss – in very few reported cases, patients have experienced hair loss or thining of the skin tissue of about 2cm at the site of injection. This is often related to the steroid used.
Unfortunately, there are some absolute contraindications to the GON block treatment which include:

Allergy to the product – we cannot administer the GON block to anybody who has a known allergy to any of the ingredients of the injection.
Open skull defects – these may occur as a result of traumatic injury or as a natural congenital disability. Injections cannot be administered in those with any sort of open skull injury.
Infection at the procedure site – any infection on the procedure site, such as a local skin infection or deeper bone infection, must resolve before we can proceed with the treatment.
Surgical site – any person who has had surgery at or near the location of the procedure will be unsuitable for treatment due to the risk of intracranial infiltration.
Bleeding disorders – coagulopathy can increase your risk of bleeding after injection, which can result in serious complications.

If any of the above side effects are persistent, or you develop a side effect not listed above and are concerned, then please give us a call as soon as possible so that we can assess your situation and treat you promptly.

FAQ

GON block works by temporarily interrupting the signal pathways to the occipital nerves, thereby stopping the relay of pain signals which trigger headaches and migraines.
Chronic headache and migraine sufferers that have failed to find effective relief with oral medication and lifestyle intervention make the best candidates for GON block treatment.
Most people report that the effects of GON block last for 3-12 weeks. Multiple treatments are required throughout the year to maintain this effect. We will discuss with you in detail how many treatments you may require during your follow-up appointment.
Usually, only one injection is needed. Pain relief can be felt almost immediately whilst the local anaesthetic is working, but this will wear off 4 hours after administration, after which your regular levels of pain will return. The steroid counterpart of the injection will start to work in a few days and should last for several months. Occasionally, two injections may be required.
Not everyone will benefit from GON block treatment. If this is the case, our doctors can review your case and help identify the source of your pain so that we can refer you to the appropriate specialist.
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Emergency Cases

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