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

A Prospective Randomized Study Comparing Greater Occipital Nerve Block Alone Versus Dual Nerve Blockade in the Management of Cervicogenic Headache and Occipital Neuralgia

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).

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