Adding a greater occipital nerve block to trigger point injections for upper trapezius neck pain.

Evaluation of the Efficacy of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients With Neck Pain and Upper Trapezius Trigger Points: A Single-Blind Randomized Controlled Trial

This will test whether adding an ultrasound-guided greater occipital nerve block to standard trigger point injections helps adults (18–65) with chronic upper trapezius trigger-point neck pain reduce pain and improve daily function.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 60 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Ankara Etlik City Hospital (Government)
• Locations: 1 site (Ankara)
• Trial ID: NCT07058636 on ClinicalTrials.gov

What this trial studies

This randomized, single-blind controlled trial at Ankara Etlik City Hospital compares standard trigger point injections alone versus trigger point injections plus an ultrasound-guided greater occipital nerve (GON) block in adults with chronic upper trapezius trigger-point neck pain. Eligible participants are 18–65 years old, meet Travell and Simons criteria for myofascial pain syndrome with active upper trapezius trigger points, have pain for more than 3 months, and report pain ≥5/10 on the VAS. Interventions include local anesthetic (2% lidocaine with saline) or steroid plus lidocaine for trigger point injections, with or without an added GON block, performed under ultrasound guidance. Key outcomes focus on changes in pain intensity and daily function after treatment, with standard exclusions such as bleeding disorders, local infection, pregnancy, and allergy to study drugs.

Who should consider this trial

Good fit: Adults aged 18–65 with chronic (≥3 months) neck pain caused by active upper trapezius trigger points diagnosed as myofascial pain syndrome and reporting pain ≥5/10 on the VAS are ideal candidates.

Not a fit: People with neck pain from other causes (for example cervical radiculopathy or structural spine disease), those with contraindications to local anesthetics or steroids, pregnant or breastfeeding individuals, or those with bleeding disorders or local infection are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, combining a GON block with trigger point injections could provide greater and faster pain relief and better daily function for people with upper trapezius trigger-point neck pain.

How similar studies have performed: Trigger point injections and occipital nerve blocks have each shown benefit for head and neck pain separately, but evidence for adding them together is limited and the combination is relatively novel.

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.

Where this trial is running

Ankara

• Ankara Etlik City Hospital — Ankara, Turkey (Türkiye) (Recruiting)

Study contacts

• Study coordinator: İlayda Gerdan, Resident Doctor

Conditions Neck Pain; Myofacial Pain Syndrome; Trigger Point Pain, Myofascial; Trigger Points; Upper Trapezius Trigger Points; Cervicogenic Headache; neck pain; myofascial pain syndrome