Cervical steroid epidural nerve blocks in the palliation of pain secondary to intractable tension-type headaches.

Headaches are among the most common pain syndromes encountered in clinical practice. Of these headaches, 70%-80% are ultimately diagnosed as tension type headaches (TTH). Most patients suffering from TTH will experience improvement when treated with traditional modalities, including tricyclic antidepressants, nonsteroidal antiinflammatory agents, and cognitive therapies. Unfortunately, not all patients respond to the traditional modalities. We wish to report 48 patients suffering from pain secondary to intractable TTH who failed to respond to traditional treatment modalities and were treated with cervical steroid epidural nerve blocks (CSENB). The average number of CSENB performed per patient was four. Average pain score prior to CSENB was 4.8. Six weeks following CSENB, the average pain score was 0.95. At 3 months follow-up, the VAS score was 0.35. These results suggest that CSENB may appear to provide effective relief of pain to some patients with intractable TTH.