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Headache Injections

Villanueva Institute of Pain and Spine

Headache Injections in Burbank, CA

Headache injections are often highly beneficial to patients suffering from chronic migraines, occipital neuralgia, cluster headaches, or headache pain unresponsive to medication, rest, lifestyle changes, or other treatments.

When these headaches become too frequent, intense, or unpredictable, they can make the activities of everyday life difficult and even unenjoyable. Things like work, sleep, exercise, family time, social plans, and even calm moments can start to revolve around worrying about when the next headache might happen.

I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at Villanueva Institute of Pain and Spine (VIPS). I offer several effective headache injection and nerve block options, including Botox for chronic migraine, occipital nerve blocks, and SPG blocks. Before recommending any treatment, I will take the time to review your headache pattern, medical history, prior treatments, exam findings, imaging (if needed), and also how these headaches are affecting your daily life.

Many patients come to VIPS after trying multiple medications or seeing different providers without enough relief. I often hear how patients have been told they have migraines, tension headaches, occipital neuralgia, cervicogenic headaches, or cluster headaches, but still do not feel like anyone has connected the pieces. At VIPS, my team and I listen closely, explain what we are looking for, and help you understand which treatment options may make sense.

If you are looking for headache injections in Burbank, CA, call VIPS at (818) 669-8895 or conveniently request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

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What Are Headache Injections?

Headache injections are focused treatments used to reduce or interrupt pain signals involved in certain headache disorders. Depending on your diagnosis, this may include Botox for chronic migraine, an occipital nerve block, an SPG block, or another targeted injection or nerve block.

These treatments differ in their applications:

  • Botox is typically used to prevent chronic migraine.
  • Occipital nerve blocks target nerves at the back of the head involved in occipital neuralgia, migraine, or headaches originating in the neck or scalp.
  • SPG blocks address the sphenopalatine ganglion, which is linked to specific headache and facial pain patterns.

 

The appropriate treatment depends on the pain’s origin, frequency, characteristics, previous treatment responses, and whether symptoms indicate nerve, muscle, joint, migraine, or mixed pain patterns.

What Types of Headaches Can Injections Help?

Headache injections are most useful when the headache pattern points to a specific nerve pathway, muscle pattern, migraine process, or pain generator that can be treated directly. They may be an option for patients dealing with:

  • Chronic migraine
  • Frequent migraine headaches
  • Occipital neuralgia
  • Cervicogenic headaches
  • Headaches that start in the neck or at the base of the skull
  • Headaches with scalp tenderness, nerve pain, burning, or shooting pain
  • Cluster headache patterns in select cases
  • Facial pain patterns involving the sphenopalatine ganglion, or SPG
  • Headaches that have not improved enough with medication alone
  • Headaches that interfere with sleep, work, driving, exercise, family life, or normal daily routines


A headache that begins at the base of the skull may require a different approach than chronic migraine, and facial pain near the eye or nose may involve a different pathway than neck pain. Some patients also have more than one contributor, such as migraine combined with neck pain, occipital nerve irritation, or muscle tension. It’s my job to find the root of these issues and treat them appropriately.

Some patients may require medication management, imaging, neurological evaluation, emergency care, or referral to another specialist. If another type of care is more appropriate, I will explain the reasons and guide you on the next steps.

Botox for Chronic Migraine

Botox may be used as a preventive treatment for chronic migraine. Chronic migraine is typically considered when headaches occur on 15 or more days per month, with migraine features on at least some of those days.

Botox is not used the same way for migraine as it is for cosmetic treatment. For chronic migraine, medication is placed in specific areas around the head, neck, and shoulders based on an established injection pattern. The purpose is to reduce headache frequency and severity over time by affecting pain signaling pathways involved in migraine.

Using Botox to treat a patient with chronic migraine symptoms is not usually a one-time treatment. Patients often need a series of treatments before the full benefits become clear, and injections are commonly repeated at regular intervals when they are helping. During your consultation, I will review whether your headache pattern fits chronic migraine and whether Botox is an appropriate option based on your history and prior treatments.

Occipital Nerve Blocks

The occipital nerves are located at the back of the head, and occipital nerve blocks are specialized blocks that target this specific area. These nerves can contribute to pain that starts near the base of the skull and travels into the scalp, behind the ear, toward the temples, or over the top of the head.

Occipital nerve blocks may be considered for occipital neuralgia, certain migraine patterns, cervicogenic headaches, and headache pain associated with neck tension or nerve irritation. Some patients describe the pain as burning, shooting, stabbing, electric, or very tender to the touch.

An occipital nerve block may include a local anesthetic and, when appropriate, anti-inflammatory medication. The response may offer relief and may also help clarify whether the occipital nerves are involved in your headache pattern.

SPG Blocks

The sphenopalatine ganglion (SPG) is a nerve bundle located deep behind the nasal cavity. The SPG is involved in certain headaches, migraine, facial pain, and autonomic symptoms, such as tearing, nasal congestion, or pain around the eye or face.

An SPG block is often administered carefully through the nose. We use a small applicator or catheter to deliver numbing medication near the SPG region. SPG blocks may be considered for certain migraine, cluster headache, or facial pain patterns. They are not right for every headache, but they can be useful when the pain pattern suggests that the SPG may be involved.

How I Evaluate Headaches Before Recommending Injections

Before recommending Botox, an occipital nerve block, an SPG block, or another headache treatment, I want to understand your headaches in detail. Headaches can come from many sources, and the treatment must match the pattern. Some patients have one clear headache diagnosis. Others have more than one contributor, such as chronic migraine combined with neck pain, occipital nerve irritation, jaw tension, sleep disruption, or cervical spine problems. A careful evaluation helps us avoid treating every headache as if it has the same cause.

During your consultation, I may review:

  • How often your headaches occur
  • Where the pain starts and where it travels
  • Whether symptoms include nausea, light sensitivity, sound sensitivity, aura, tearing, congestion, scalp tenderness, neck pain, numbness, tingling, or weakness
  • Whether headaches disturb sleep, work, driving, exercise, family life, or social plans
  • What medications or treatments you have already tried
  • Prior imaging, neurology records, procedure notes, or emergency visits
  • Neck, nerve, muscle, and spine-related factors that may contribute to headache pain
  • Whether imaging, EMG/NCS testing, medication review, or referral to another specialist may be needed

Good Candidates for Headache Injections in Burbank

You may be a good candidate for headache injections if your symptoms, history, and exam suggest that Botox, an occipital nerve block, or an SPG block may help your specific headache pattern.

Suitable headache injection candidates have frequent migraines, chronic migraine, headache pain that begins at the base of the skull, scalp nerve tenderness, headaches associated with neck pain, cluster headache features, or facial pain patterns that may involve the SPG.

Headache injections may also be considered when traditional medications have not provided enough relief, cause unwanted side effects, or do not fit well with your overall care plan. Some patients use injections as part of a more extensive headache strategy that includes medication management, rehabilitation, lifestyle changes, sleep support, and coordination with neurology or primary care.

The best candidates are also active participants in tracking their response. The number of headache days, headache severity, headache duration, headache triggers, rescue medication use, and functional improvement all matter when deciding whether treatment is helping.

Why Choose VIPS for Headache Injections?

Headache treatment should be thoughtful and specific. At VIPS, I do not assume that every headache is a migraine or that every migraine needs the same treatment. I look at the pattern, the person, and the life being disrupted.

When you choose VIPS, you can expect:

I am double board-certified in PM&R and interventional pain management. My PM&R background helps me consider the neck, muscles, nerves, posture, movement, function, and rehabilitation side of headache pain, while my interventional training allows me to perform targeted injections and nerve blocks when appropriate. My qualifications extend beyond double-board certification. As a Certified Life Care Planner, I have advanced specialized training in evaluating the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities, further strengthening the expertise I bring to medical-legal consulting and expert witness services.

I review your headache history, prior care, medication response, exam findings, and related neck or spine symptoms before recommending Botox, an occipital nerve block, an SPG block, or another option.

Headaches may involve migraine pathways, occipital nerves, cervical spine joints, muscle tension, facial pain channels, sleep, stress, and several overlapping factors. I try to understand how those pieces fit together before choosing a plan.

If a headache injection makes sense, I will explain why. If medication management, imaging, neurology evaluation, physical therapy, cervical spine treatment, or another approach is more appropriate, I will tell you directly.

Relief matters, but so does what relief allows you to do. I want to know whether headaches are limiting your work, school, sleep, exercise, parenting, driving, social life, or ability to make plans without fear of the next flare.

Many patients come to VIPS after feeling dismissed, rushed, or unsure where to turn. My team and I want you to be acknowledged, informed, and comfortable asking questions before any treatment is performed.

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What Happens During Headache Injection Treatment?

For Botox for chronic migraine, small injections are placed in specific areas of the head, neck, and shoulders. The visit is usually straightforward, and most patients return to normal activities afterward with basic instructions.

During an occipital nerve block treatment, I will identify the treatment area near the back of the head and upper neck. The skin is cleaned, and medication is injected near the occipital nerves. You may feel pressure or brief discomfort during the injection.

For an SPG block, the team will administer numbing medication via the nose into the SPG region. Some patients feel pressure, a bitter taste, throat numbness, or temporary nasal discomfort depending on the approach used.

What Should You Expect After Headache Injections?

After headache injections, your response depends on the treatment performed and the headache pattern being treated.

Occipital nerve blocks and SPG blocks may provide relief sooner because they frequently involve a local anesthetic. Relief may be temporary, longer-lasting, or limited depending on whether the targeted nerves are part of your headache pattern.

Botox migraine injections usually work more gradually. Some patients notice improvement after the first treatment cycle, while others need more time before the benefit is clear. Tracking headache days, migraine days, severity, and medication use can help determine whether Botox is helping.

Mild soreness, tenderness, bruising, numbness, pressure, or temporary discomfort can occur after treatment. I will review what is expected and when to contact the office.

How Long Do Headache Injection Results Last?

The duration of relief depends on the treatment, diagnosis, and your body’s response.

  • Botox for chronic migraine is typically repeated on a regular schedule when it is helping.
  • Occipital nerve blocks may provide relief that lasts hours, days, weeks, or longer, depending on the pain source and medication used.
  • SPG block results also vary, and some patients may need a series of treatments or an expanded headache plan.


For some patients, fewer headache days may be the most meaningful improvement. For others, it may be shorter flares, less intense pain, fewer rescue medications, better sleep, or more confidence in making plans. We will use your response to decide whether to continue, adjust, or consider another treatment.

Headache Injections and Your Broader Treatment Plan

Depending on your symptoms, your plan may include medication management, physical therapy, posture and neck rehabilitation, sleep support, trigger management, imaging, neurology coordination, or treatment of cervical spine pain.

If your headaches are driven by chronic migraine, Botox may be appropriate. If the pain starts at the back of the head or involves scalp nerve tenderness, an occipital nerve block may help. If symptoms involve certain facial pain or cluster-like patterns, an SPG block may be considered.

At VIPS, you and I will take ample time to review your symptoms, exam findings, history, response to previous treatment attempts, and daily limitations. Headache care should not only reduce pain. It should help you spend less of your life planning around the next attack.

Headache Injections in Burbank, CA

VIPS is located in Burbank, CA, in the Magnolia Park neighborhood. Our office is designed to feel welcoming and personal, with comfortable seating, warm finishes, and original artwork from patients who are working artists.

This is not meant to feel like a rushed pain clinic. I live and work in Burbank, and I care about building a practice where patients are known, not processed. For patients who need a higher level of care, Providence St. Joseph Medical Center is nearby, where I also serve as a staff pain management specialist.

We see patients from Burbank, Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

Burbank Headache Injection FAQs

If headaches or migraines are making your days harder to plan, work through, or enjoy, Botox, occipital nerve blocks, SPG blocks, or another targeted treatment may help clarify the next step in your care. To schedule a headache injection consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today.

Yes. Botox for chronic migraine follows a medical injection pattern involving specific areas of the head, neck, and shoulders. The purpose is not cosmetic improvement. The purpose is to help reduce migraine frequency and severity for properly selected chronic migraine patients.

Botox is generally considered for chronic migraine, which usually means headaches on 15 or more days per month, with migraine features on at least some of those days. I will review your headache frequency, symptoms, prior treatments, medication history, and insurance requirements before recommending Botox.

An occipital nerve block is an injection near the occipital nerves at the back of the head. It may be considered when headaches begin near the base of the skull, travel into the scalp, or involve occipital neuralgia, migraine, neck-related headache pain, or scalp nerve tenderness.

Occipital neuralgia often causes sharp, shooting, burning, electric, or stabbing pain that begins near the back of the head or upper neck and travels into the scalp. Some patients also notice tenderness when touching the scalp or pain behind the ear or in the temple area.

Most patients tolerate headache injections well. You may feel brief pinching, pressure, tenderness, or temporary discomfort depending on the treatment. I will explain what to expect before we begin so the process feels more comfortable and predictable.

It depends on the treatment. Occipital nerve blocks and SPG blocks may work more quickly because they often use a local anesthetic. Botox for chronic migraine usually works gradually, and some patients need more than one treatment cycle before the benefit is clear.

Results vary. Botox for chronic migraine is usually repeated at regular intervals when it is helping. Occipital nerve block and SPG block relief may last for hours, days, weeks, or longer, depending on the diagnosis, medication used, and your response.

For some patients, successful headache treatment may lessen reliance on rescue medications or make headache flares easier to manage. This depends on the diagnosis, response to treatment, and broader medication plan. Any medication changes should be discussed before making adjustments.

Not always. Some headache patterns can be evaluated through history and physical exam, while others may require imaging or referral to another specialist. If your symptoms imply a need for MRI, CT, neurological evaluation, or urgent care, I will explain why.

Seek urgent medical care if you have a sudden, severe headache, the worst headache of your life, a headache with weakness or confusion, trouble speaking, vision loss, fever, seizure, head injury, or a new headache that feels very different from your usual pattern.

If a headache injection does not provide meaningful relief, that information still helps. It may mean the headache is coming from another source, that a different treatment should be considered, or that additional evaluation is needed. I will review your response with you and discuss the next appropriate step.

The cost of headache injections in Burbank can vary depending on the treatment performed, whether Botox, an occipital nerve block, an SPG block, or another procedure is recommended, and your insurance benefits. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.

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