Efficacy of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients With Neck Pain

Launched by ANKARA ETLIK CITY HOSPITAL · Jul 1, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether adding a treatment called a Greater Occipital Nerve (GON) block to the usual trigger point injections can help people with neck pain feel better and move more easily. Trigger points are small, tight spots in neck muscles that can cause pain. The study will compare two groups: one receiving just the trigger point injections, and the other receiving both the injections and the GON block, which is an injection near a nerve at the back of the head to reduce pain. Everyone will also do the same home exercises to help strengthen and stretch their neck muscles.

Adults aged 18 to 65 who have had neck pain for more than three months, with pain rated at least 5 out of 10, and who have specific painful spots in their upper shoulder muscle (called trigger points) may be able to join. Participants can expect to receive injections and follow a guided exercise plan, with regular check-ins by phone. Their pain levels, neck movement, daily function, and quality of life will be measured before treatment and again at 1 week and 4 weeks after treatment. The goal is to see if combining these two treatments provides better relief and helps people return to their usual activities more comfortably and quickly.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged between 18 and 65 years.
• • Diagnosed with myofascial pain syndrome (MPS) based on the major and minor criteria described by Travell and Simons (a diagnosis requires all 5 major and at least 1 minor criterion)
• • Presence of active trigger points in the upper trapezius muscle.
• • Patients with neck pain lasting longer than 3 months.
• • Pain intensity of ≥5 on the Visual Analog Scale (VAS).
• Exclusion Criteria:
• • Elderly, pediatric, pregnant, postpartum, or breastfeeding individuals; patients in intensive care; unconscious individuals; or legally incapacitated persons.
• • Known allergy to local anesthetics used in trigger point injection (e.g., lidocaine, bupivacaine) or to other drugs used (e.g., corticosteroids).
• • Patients with bleeding disorders (e.g., hemophilia, thrombocytopenia) or those currently on anticoagulant therapy.
• • Presence of active infection at or near the injection site, or any systemic infection; impaired skin integrity.
• • Patients with psychiatric disorders that may interfere with treatment response or affect study outcomes.
• • Patients with severe neurological or cardiovascular disorders, or with uncontrolled diabetes.
• • Patients with cervical disc pathologies with radiculopathy.
• • History of receiving shoulder injection, trigger point injection, dry needling, manual therapy, or electrotherapy within the past 3 months.
• • History of cervical or shoulder surgery.
• • Patients diagnosed with adhesive capsulitis, rotator cuff tendinopathy, or shoulder impingement syndrome.
• • Diagnosis of fibromyalgia.
• • Presence of active trigger points in other back muscles.