A Prospective Randomized Study Comparing Greater Occipital Nerve Block Alone Versus Dual Nerve Blockade in the Management of Cervicogenic Headache and Occipital Neuralgia
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 160
- Locations
- 1
- Primary Endpoint
- Change in pain intensity measured by the Visual Analog Scale (VAS)
Study Overview
Brief Summary
This study looked at two types of nerve block injections used to treat people with cervicogenic headache (CEH) and occipital neuralgia (ON)-two painful conditions that often cause pain at the back of the head and neck. The injections target nerves in the upper neck that may be causing the pain.
The researchers compared:
One nerve injection (greater occipital nerve block, or GONB), versus
Two nerve injections (GONB plus lesser occipital nerve block, or LONB).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adults aged 18 to 65 years
- •Clinical diagnosis of cervicogenic headache (CEH) and/or occipital neuralgia (ON) according to ICHD-3 criteria
- •Pain duration of more than 3 months
- •Pain localized to the occipital region, consistent with the distribution of the greater and/or lesser occipital nerves
- •Inadequate response to conservative therapy (e.g., analgesics, physiotherapy)
- •Willingness to participate and provide written informed consent
Exclusion Criteria
- •Previous nerve block or other interventional procedures for headache
- •Use of systemic corticosteroids within the past 3 months
- •Known allergy to lidocaine or other amide-type local anesthetics
- •Evidence of secondary causes of headache on imaging (e.g., tumor, infection)
- •Pregnancy or breastfeeding
- •Active infection at the injection site
- •Coagulopathy or use of anticoagulant therapy
- •Significant psychiatric or neurological comorbidities interfering with study participation
Arms & Interventions
GONB Alone
Patients received a single injection of 1 mL of 2% lidocaine at the greater occipital nerve using a landmark-guided technique.
Intervention: Greater Occipital Nerve Block (GONB) (Procedure)
GONB + LONB (Dual Block)
Patients receive two injections of 1 mL of 2% lidocaine each at the greater and lesser occipital nerves using a landmark-guided technique.
Intervention: Combined Greater and Lesser Occipital Nerve Block (GONB + LONB) (Procedure)
Outcomes
Primary Outcomes
Change in pain intensity measured by the Visual Analog Scale (VAS)
Time Frame: Baseline, 24 hours, 3 weeks, and 3 months post-intervention
ain intensity was assessed using a 10-point Visual Analog Scale (VAS), with 0 indicating no pain and 10 indicating the worst pain imaginable. VAS scores were recorded at baseline and follow-up visits.
Secondary Outcomes
No secondary outcomes reported
Investigators
Ali Hammed
Dr
Tishreen University Hospital