Procedures

What is Botox PREEMPT Protocol?
- The PREEMPT protocol (Phase III Research Evaluating Migraine Prophylaxis Therapy) is the standardized regimen used for Botox (onabotulinumtoxinA) treatment of chronic migraines. It was developed and validated through the PREEMPT clinical trials, which led to FDA approval of Botox for chronic migraine prevention in 2010.
- Completed every 12 weeks, using 155-195 Units of Botox.

What are Greater and Lesser Occipital Nerve Blocks?
- Occipital nerve blocks are a common treatment for certain types of headaches, including migraines, cluster headaches, and occipital neuralgia. They involve injecting a combination of anesthetic (like lidocaine or bupivacaine) and sometimes a corticosteroid near the greater and/or lesser occipital nerves, which are located at the base of the skull.
What is a Sphenopalatine Ganglion Nerve Block?
- Sphenopalatine ganglion (SPG) blocks are another minimally invasive treatment option for certain headaches and facial pain disorders, including migraines, cluster headaches, and trigeminal neuralgia. The SPG is a collection of nerves located deep behind the nose, linked to the trigeminal nerve — a major pain pathway in the head and face.
What is a Trigeminal Nerve Block?
- Trigeminal nerve blocks are used to treat severe or chronic facial pain involving the trigeminal nerve, which is the main sensory nerve of the face and head. They're particularly helpful for conditions where other treatments (like oral meds or Botox) haven’t provided enough relief.

What are Trigger Point Injections?
- Trigger point injections (TPIs) are a targeted treatment for myofascial pain syndrome — a condition where tight, irritated muscle knots (called trigger points) cause local or referred pain. These injections help deactivate the knots and relieve pain, especially when physical therapy and stretching alone aren’t enough.
- In the headache clinic trigger point injections are used to treat upper back, and neck pain worsening migraine and headache symptoms.