The Efficiency of Peripheral Nerve Blockade and Trigger Point Injections in the Treatment of Chronic Tension-Type Headache

Purpose: Greater and lesser occipital nerve blockade (GONB/LONB) using local anesthetics with and without corticosteroids, andsupraorbital and supratrochlear nerve blockade (STNB) using local anesthetics and trigger point injections (TPI) are commonlyemployed for the treatment of primary and secondary headache disorders. In this study, we aimed to investigate the efficiencyof peripheral nerve blockade in the treatment of chronic tension-type headache.Patients and Methods: A total of 174 patients who received GONB and/or STNB with or without TPI between June 2013 andOctober 2016 were included in this study. The patients were divided into three groups as GONB, GONB+STNB, GONB+STNB+TPIand followed up for four weeks with VAS score. In the GONB alone group, triamcinolone and bupivacaine were used, and in theremaining two groups, only bupivacaine was administered.Results: The mean age of the study population was 43.2±7.2 years. Female dominance was present. There were no statisticallysignificant differences between the three groups regarding age and gender. Furthermore, headache frequency and VAS scoresof the groups did not significantly differ before treatment; however, significant differences were observed (in both) betweenand within groups after treatment. The response rates were significantly higher (50% and 75%) in the last treatment group.Conclusion: In this study, TPI combined with GONB and STNB was superior to GONB+STNB and GONB alone regarding headachefrequency. We also found that in all groups, post-treatment VAS scores and headache frequency were lower compared to pretreatment values.