Specialized treatment foils complex headache syndrome.

Gary Brinson, 60, was a warehouse supervisor for a fertilizer plant until 2012, when he fell at work and his world turned upside down. Injuries he

Photo by Nerissa Johnson.

Gary Brinson

suffered from the fall disabled him. They also worsened pain he was experiencing beforehand.

“I was already having massive headaches,” the Indiana native shares. “Then when I fell, I broke my shoulder. But when I tried to do physical therapy, I couldn’t do it because my neck and head hurt too bad. And when I tried to do physical therapy on my neck, I couldn’t because my shoulder hurt too bad.

“I had surgery on my shoulder and neck. During the neck surgery, the surgeon went through the front and put in bone grafts as well as plates, cages and screws. But I was still having headaches, so he went in through the back of my neck and put spacers in my vertebrae.”

Unfortunately, neither neck surgery eased Gary’s headaches. His problem, according to his orthopedic surgeon, was severe arthritis leading to degenerative disc disease. The damaged discs in his neck were placing pressure on the delicate nerves going into his head. That caused the painful symptoms he was experiencing.

“My neck was stiff, so I couldn’t turn my head without excruciating pain,” Gary describes. “The pain was constant. It felt like someone was trying to pull off my forehead. And my wife says I was grouchy.

“The headaches came from the back of my skull. They went through the sides of my head right into my eyes. They were debilitating. On a scale of one to ten, they were at least an eight or nine on most days. All I could do was lie in bed with my eyes closed and try to sleep, or put in my earbuds and listen to music real low to take my mind off the pain.

“I couldn’t drive or ride in a car for very long. If I sat in a chair, I had to get up after a while and move. I had to alternate positions and movements often to keep from stiffening up and hurting worse. I couldn’t ride my motorcycle, and I’ve been riding since I was ten. It’s my passion. We bought a brand-new bike in 2011, and it was just sitting out in the shed.”

After the neck surgeries failed to give Gary relief from his headaches, his orthopedic surgeon referred him to Kai McGreevy, MD. Dr. McGreevy is a board-certified neurologist and pain management specialist at McGreevy NeuroHealth, which has offices in Palm Coast and St. Augustine. Dr. McGreevy uses a wide range of advanced therapies to treat pain and many other conditions associated with nerve disorders.

“Gary had undergone cervical fusion surgery in the past, but areas above the fusion were now degenerating,” Dr. McGreevy reports. “Imaging revealed arthritis in his upper cervical spine. Arthritis in this area of the spine can refer pain up into the occipital region at the back of the head, and that can trigger headaches. We call this cervicogenic headache syndrome.”

Initially, Dr. McGreevy treated Gary’s headache syndrome with conservative measures, including medication and physical therapy. He tried interventional techniques, such as epidural injections and facet nerve blocks, as well, but none of these treatments provided the desired relief.

“I received a little pain relief with the injections,” Gary states. “It felt wonderful to get any relief at all, but then the pain got to a point where we had to try something else. That’s when Dr. McGreevy suggested occipital nerve stimulation.”

Occipital nerve stimulation works through an implanted device that interferes with pain signals traveling from the occipital nerves at the base of the skull to the brain. The interruption eases both neck pain and headaches. Before a permanent stimulator is implanted, Dr. McGreevy provides patients with a stimulator trial.

“In setting me up for the trial, Dr. McGreevy placed the wires over the nerves in my neck and taped the battery to my back,” Gary explains. “For four days, I was headache free, so I decided to go with the permanent stimulator.”

Adjustable Relief

When a patient is fit with an occipital nerve stimulator, one electrode lead is placed in their cervical epidural space and two smaller leads are inserted under the skin on each side of their head. The leads cover an area called the occipital ridge that runs along the back of the head where the base of the cranium sits, Dr. McGreevy observes.

“The first lead overlies the occipital nerves as they move off into the head,” the doctor explains. “The two smaller leads serve as peripheral nerve Graphic courtesy of as they extend over the occipital ridge.

“We position the leads this way to cover the cervical pain as well as the headache pain. All three leads are attached to the same battery. With occipital nerve stimulators, the battery is placed either in the area of the low back or over the buttocks.”

Gary received 100 percent relief from his occipital nerve stimulator trial. That made him an excellent candidate for stimulator implantation, which was performed by a neurosurgeon in late 2018. To ensure that the leads stay secure, there are limitations during the healing process on twisting and bending movements that could dislodge them.

“The incidence of lead migration is very low,” Dr. McGreevy assures, “but we still take precautions for at least two weeks.”

When that two-week period ended and Gary had recovered from the implantation surgery, his occipital nerve stimulator was activated.

“Gary was still having daily headaches during his recovery period,” Dr. McGreevy informs. “But the moment the stimulator was turned on, he noticed dramatic relief from his headache pain, as well as a significant decrease in headache severity and frequency. If he starts to get a headache, he simply changes the stimulator’s setting to reduce the headache’s impact.”

“The occipital nerve stimulator is amazing,” Gary offers. “It has an adjustable remote control, and if I start hurting, I just turn it up a little bit. If the headache is really bad, I can turn it up a little more. I adjust the stimulation to my pain level. It’s been a godsend.”

Dr. McGreevy believes occipital nerve stimulation is an excellent and underused option for people with cervicogenic headache syndrome that’s resistant to other conservative and interventional therapies.

“This treatment is truly a game-changer,” he says. “It certainly has been for Gary, and I am finding that many other patients are also receiving long-term pain relief with occipital nerve stimulation.”

On the Road Again

Gary achieved dramatic pain relief from his treatment at McGreevy NeuroHealth. Before he received his occipital nerve stimulator, Gary’s pain hovered at an eight or nine on a scale of one to ten. But with the device, his pain level is significantly lower and easily managed. And because the stimulator is implanted, there’s nothing keeping him from the open road.

Photo by Nerissa Johnson.

Gary Brinson

“On a daily basis, my pain averages maybe a two now,” he states. “If I do get a headache, I just adjust the stimulator with the remote control. The further up I adjust it, the more pain it takes away. It’s incredible. I feel like a new person.

“I’m back to riding my motorcycle, which I love to do. My wife recently retired, and we bought a camper, so we’re enjoying life as best we can. With her being retired and me being disabled, the only things interrupting our schedules are our doctor appointments.”

With his occipital nerve stimulator, Gary is “enjoying life” again.

Gary doubts he’d be enjoying life as much as he is were it not for Dr. McGreevy and his staff.

“Dr. McGreevy is awesome,” he raves. “He takes the time to fully explain everything, and he answers all of my questions. He makes sure I understand exactly what’s going to happen and what kind of results I should expect.

“The staff at McGreevy NeuroHealth is wonderful. They’re friendly, helpful and patient oriented. Whenever I go to the office, it’s just like going home. They always make me comfortable.

“I’m on several groups on Facebook for spinal cord stimulators for the back and neck, and those are wonderful sources of information. People who are thinking about getting stimulators can ask questions, and people like me who’ve got them can describe their experiences. I’ve recommended
Dr. McGreevy to a large number of people because he is an awesome doctor. I’m very appreciative that my orthopedic surgeon sent me to him.”

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    • McGreevy Neuro Health

      Your neurological health is nothing to worry about when you visit McGreevy NeuroHealth, conveniently located between Saint Augustine and Jacksonville, Florida. Their facility hosts a qualified interventional pain physician who is also a board-ce... Read More

    • Kai McGreevy, MD

      Kai McGreevy, MD, is board certified in neurology and pain medicine by the American Board of Psychiatry and Neurology. His medical training includes completion of a neurology residency at the University of California, San Diego, and an interven... Read More