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What techniques do you use to help reduce procedural pain for headache injection treatments?

In light of the publication from Cheng et al., PMID 41472639, on remote electrical neuromodulation for reducing procedural pain.
3 Answers
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Neurology · UPMC
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In my clinic, none of the providers, to my knowledge, use any specific techniques to reduce procedural pain. We do offer ice packs that patients can use during or after a procedure. We do Botox and pericranial nerve blocks. It would be difficult to coordinate using REN prior to procedures. I suppose...

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Neurology · Greater Boston Headache Center at Boston Advanced Medicine
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The only procedure I do for headache/face pain is botulinum toxin injections. Since the introduction of the CGRP antibodies, I have not done them anymore for chronic migraine; however, I find the antibodies more effective, better tolerated, and easier to use. I still do botulinum toxin injections in...

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Neurology · Hartford HealthCare
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If they receive nerve blocks or trigger point injections, then I counsel them on using ice if they have post-procedural discomfort, but no heat on those areas, as it could encourage bleeding. Post-Botox procedural discomfort, I don’t have a great strategy for, as the patient should avoid putting ice...

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