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

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 if patients already have it, they can be counseled on using their own REN device 10-45 mins before a procedure. We have not done that in my practice. Due to the high cost of neuromodulation devices, ...

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 the masseter muscles for temporomandibular disorder (TMD), also to prevent headaches, including migraine headaches. Pain is not an issue as I use a very fine needle (30 G) and take my time to do the ...

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 or pressure of any kind on the injection sites for about 2 days, so as not to move the medication into a “wrong” or undesired location. The article is interesting using REN for post-Botox pain, but l...