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

Tishreen University Hospital

Status: Completed

Conditions: Occipital Neuralgia (ON); Ervicogenic Headache (CEH)

Treatments: Procedure: Greater Occipital Nerve Block (GONB); Procedure: Combined Greater and Lesser Occipital Nerve Block (GONB + LONB)

Study type: Interventional

Funder types: Other

Identifiers

NCT07068451

N/2020-31

Details and patient eligibility

About

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).

Enrollment: 160 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion 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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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160 participants in 2 patient groups

GONB Alone

Experimental group

Description:

Patients received a single injection of 1 mL of 2% lidocaine at the greater occipital nerve using a landmark-guided technique.

Treatment:

Procedure: Greater Occipital Nerve Block (GONB)

GONB + LONB (Dual Block)

Experimental group

Description:

Patients receive two injections of 1 mL of 2% lidocaine each at the greater and lesser occipital nerves using a landmark-guided technique.

Treatment:

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