RECRUITINGINTERVENTIONAL

Clinical Study of Myofascial Trigger Points(MTrPs) Injection in the Treatment of Chronic Cervicogenic Headache

Clinical Study of Myofascial Trigger Points(MTrPs) Injection in the Treatment of Chronic Musculoskeletal Pain(CMP), Chronic Migraine and Cervicogenic Headache

About This Trial

Chronic cervicogenic headache is a common disease in China, with a high incidence among the elderly, and has a significant impact on patients' quality of life. Currently, both domestic and international studies have confirmed that glucocorticoid injection at myofascial trigger points(MTrPs) can alleviate patients' pain symptoms. MTrPs injection is safe and easy to operate, and can improve the clinical management efficiency of patients with chronic cervicogenic headache. Therefore, we designed a prospective, randomized controlled, blinded outcome, non-inferiority study to compare the long-term clinical efficacy of glucocorticoid injection at myofascial trigger points and greater occipital nerve block injection in treating chronic cervicogenic headache. Patients will be randomly divided into two groups and receive either glucocorticoid injection at MTrPs or dorsal rami blocks of C2 spinal nerves. After treatment, patients will be followed up for 2 years. Their NRS scores, attack frequency, attack duration, HIT-6 scores, Patient Global Impression of Change(PGIC) scale, and adverse reactions will be recorded at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 24 weeks. If the results indicate that the clinical efficacy of myofascial trigger point injection for chronic cervicogenic headache is not inferior to that of injection at intra-articular injection, it will provide a safe and simple treatment option that is easy to promote for patients who do not respond to conservative treatment.

Who May Be Eligible (Plain English)

Who May Qualify: - Diagnosed with cervicogenic headache by at least two pain specialists or neurologists; - Disease duration of at least 3 months; - Age between 18 and 65 years; - Numerical Rating Scale (NRS) score ≥ 3 despite conservative pharmacological treatment; - Signed willing to sign a consent form form. Who Should NOT Join This Trial: - History of allergy to trial medications such as corticosteroids; - Alcohol abuse; long-term use of opioids (exceeding 2 weeks or more than 3 days per week for over 1 month); suspected use of sedative or analgesic medications; patients on long-term steroid therapy; - Severe neurological disorders, significant hepatic or renal dysfunction, heart failure, coagulation abnormalities, gastric ulcer, diabetes, inflammatory rheumatic diseases, etc.; - Inability to use pain assessment scales; - Presence of local or systemic infection; - Pregnant or lactating patients. Always talk to your doctor about whether this trial is right for you.

Original Eligibility Criteria

View original clinical language

Inclusion Criteria: * Diagnosed with cervicogenic headache by at least two pain specialists or neurologists; * Disease duration of at least 3 months; * Age between 18 and 65 years; * Numerical Rating Scale (NRS) score ≥ 3 despite conservative pharmacological treatment; * Signed informed consent form. Exclusion Criteria: * History of allergy to trial medications such as corticosteroids; * Alcohol abuse; long-term use of opioids (exceeding 2 weeks or more than 3 days per week for over 1 month); suspected use of sedative or analgesic medications; patients on long-term steroid therapy; * Severe neurological disorders, significant hepatic or renal dysfunction, heart failure, coagulation abnormalities, gastric ulcer, diabetes, inflammatory rheumatic diseases, etc.; * Inability to use pain assessment scales; * Presence of local or systemic infection; * Pregnant or lactating patients.

Treatments Being Tested

PROCEDURE

MTrPs injection

The volume of infiltration solution is determined by the number of trigger points, with each trigger point receiving 1 mL of injection volume. The injection solution is prepared by combining 1 mL of triamcinolone acetonide (40 mg/mL), lidocaine, and normal saline, resulting in a final lidocaine concentration of 1%. A 25-gauge needle is used to inject perpendicular to the skin surface at the selected tender points, with the solution administered as a single bolus into each tender point within 10 seconds.

PROCEDURE

C2 dorsal root ganglion blocks

Patients in the nerve block group received ultrasound-guided bilateral dorsal root ganglion blocks of C2 spinal nerve. The injection solution was prepared using 1 ml of 2% lidocaine and 1 ml of triamcinolone acetonide (40 mg/mL), with a volume of 1 ml administered per side.

Locations (1)

Beijing Tiantan Hospital

Beijing, Beijing Municipality, China