Greater Occipital Nerve Block Alone Versus Dual Nerve Block in Cervicogenic Headache and Occipital Neuralgia

Tishreen University Hospital160 enrolled

Overview

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 Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

160

Conditions

Ervicogenic Headache (CEH)Occipital Neuralgia (ON)

Interventions

A landmark-guided injection of 1 mL of 2% lidocaine administered at the anatomical location of the greater occipital nerve (GON) to treat cervicogenic headache and occipital neuralgia. Performed without corticosteroids or imaging guidance.

Combined Greater and Lesser Occipital Nerve Block (GONB + LONB)PROCEDURE

Two landmark-guided injections of 1 mL of 2% lidocaine each at the anatomical locations of the greater and lesser occipital nerves. Performed without corticosteroids or imaging, targeting broader nerve involvement in cervicogenic headache and occipital neuralgia.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Change in pain intensity measured by the Visual Analog Scale (VAS)

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.

Time frame: Baseline, 24 hours, 3 weeks, and 3 months post-intervention