Headache

When should headaches be evaluated by a specialist?

Occasional headaches are nearly universal, but headaches that occur 15 or more days per month, fail to respond to usual medications, follow a neck injury, or consistently start at the base of the skull deserve specialty evaluation. Sudden "worst headache of your life," headache with fever and stiff neck, or headache with neurologic changes are emergencies — call 911.

What types of headache respond to interventional treatment?

Two patterns respond particularly well. Occipital neuralgia — irritation of the occipital nerves at the back of the head — causes shooting or electric pain from the skull base toward the scalp. Cervicogenic headache is pain referred to the head from arthritic joints or other structures in the upper neck. Both are frequently mistaken for migraine and both can be confirmed with diagnostic nerve blocks.

How are these headaches treated?

Occipital nerve blocks serve as both diagnosis and treatment, often providing weeks to months of relief. For cervicogenic headache, blocks and radiofrequency ablation of the upper cervical facet nerves address the true source in the neck. Dr. Eaddy coordinates care with your neurologist or primary physician so interventional treatment complements — rather than replaces — your overall headache management.

What should I bring to a headache evaluation?

Bring a list of current and previously tried medications, any imaging of your head or neck (or where it was done), and notes from your neurologist or primary physician if you have them. A simple headache diary — when headaches occur, where they start, and what helps — is especially useful for identifying patterns such as occipital neuralgia or cervicogenic headache.

Who is a candidate for interventional headache care?

Candidates generally have a pattern suggesting occipital neuralgia or a headache referred from the cervical spine, persistent symptoms despite appropriate medical care, and an examination that identifies a plausible nerve or joint target. Most migraine care remains with primary care or neurology; interventional treatment complements rather than replaces that care.

What are the risks and side effects of treatment?

Nerve blocks can cause temporary soreness, bruising, bleeding, infection, medication reaction, numbness, or a brief rise in blood sugar when steroid is used. Radiofrequency ablation may cause temporary neuritis or scalp numbness. Serious nerve or vascular injury is rare but is reviewed before a cervical procedure.

Does insurance or Medicare cover interventional headache treatment?

Coverage varies by diagnosis and procedure. Some plans cover medically necessary diagnostic nerve blocks or cervical procedures when examination findings and prior treatment are documented; others limit coverage for specific headache diagnoses. The office checks benefits and prior-authorization requirements before scheduling.

Before your visit

The questions above address headache patterns, candidacy, diagnosis, treatment, risks, insurance, and what to bring. Sudden severe headache, fever with a stiff neck, new weakness, confusion, or other neurologic change requires emergency evaluation rather than an office appointment.

Trusted resources

Learn more about headache disorders from these independent medical sources:

• MedlinePlus (National Library of Medicine) — Headache
• MedlinePlus (National Library of Medicine) — Migraine
• NINDS (National Institutes of Health) — Headache
• American Migraine Foundation — What Is Migraine?

Related care

Conditions and treatments connected to this page, all provided by Dr. Eaddy:

• Radiofrequency Ablation — longer-lasting relief for facet, sacroiliac, and knee arthritis pain
• Peripheral Nerve Stimulation — targeted relief for single-nerve pain
• Neck Pain — relief for cervical pain, stiffness, and nerve symptoms

Medically reviewed by Kenneth J. Eaddy, MD · Last reviewed: July 29, 2026