Locally injected steroids apparently don't enhance treatments for acute headache or migraine pain.
A study by neurologists at the Jefferson Headache Center at Thomas Jefferson University Hospital in Philadelphia did not show any benefit to adding steroids to local anesthetics to treat daily headaches.
According to Avi Ashkenazi, M.D., assistant professor of neurology at Jefferson Medical College of Thomas Jefferson University, greater occipital nerve block (GONB) is a technique to treat acute headaches by locally injecting anesthetics such as lidocaine just under the skin to provide acute pain relief for acute headache attacks and migraines. Such treatments can work quickly, perhaps in seconds or by five to 10 minutes, and its effectiveness could last from hours to two or three days to several weeks. Treatment can be repeated if needed, he notes, and it has few side effects.
There are two ways to block the occipital nerves: by injecting a local anesthetic alone or by adding an anti-inflammatory steroid along with the anesthetic. No data exist whether one is better than the other, but the use of corticosteroids is controversial because of their potential side effects, such as hair loss at the site of injection. He notes that there is no consensus among headache experts about steroid use for headache.