My wife has severe occipital neuralgia. Or at least that's what we think it is - severe neck pain at least. The pain started at her upper neck and spread to her face, back, legs, arms, etc. We aren't sure the exact cause, but it is likely from a craniotomy that she had several years ago to remove a benign tumor. We think it might have damaged some nerves when they cut her noggin open.
Anyway, two months ago she had facet injections and nerve blocks, x-ray guided under general anasthesia, with lidocaine and cortisone. The short acting lidocaine actually completely took away all her pain for the first day. We took that as a good sign that they found the source, which we think is the occipital nerve. Since they did the facets I guess we can't rule that out either though. It took about a week of pain and time off work to recover and for the cortisone kick in, but they ended up giving her a good 6-8 weeks of relief. Unfortunately, now the pain is back just like before. It started back at the neck, and like before, spread elsewhere.
We're going to see her doctor again on Friday for next steps. She's pretty bummed that they only lasted this long and now the pain is back.
I've been reading of all the other options - more injections, radiofrequency ablation, decompression surgery, gamma knife, etc, etc.
Anyone who has been in a similar situation have any advice or things to ask the doc? All of the procedures seem to have risks and benefits. I suppose they might just want to do injections again, but I'm not sure how often we can keep doing those.