Myofascial trigger point steroid injection versus greater occipital nerve block for chronic migraine

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

This trial will test whether steroid injections into myofascial trigger points work as well as greater occipital nerve block for adults (18–65) with chronic migraine who still have moderate pain despite treatment.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 1036 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Beijing Tiantan Hospital (Academic / other)
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT07347067 on ClinicalTrials.gov

What this trial studies

This is a prospective, randomized, blinded-outcome, non-inferiority trial comparing glucocorticoid injections at myofascial trigger points (MTrPs) with greater occipital nerve block in adults with chronic migraine. Eligible patients are randomized to one of the two injection approaches and followed for two years with regular visits. Key outcomes include pain intensity (NRS), headache attack frequency and duration, HIT-6 scores, and patient global impression measures. The design targets patients with at least 3 months of disease and persistent pain (NRS ≥3) despite conservative pharmacologic therapy.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18–65 with a confirmed diagnosis of chronic migraine for at least 3 months, NRS ≥3 despite prior conservative treatment, and able to consent and attend follow-up visits.

Not a fit: Patients who are pregnant or breastfeeding, allergic to corticosteroids, on long-term steroid therapy, with severe comorbidities or active infection, or those with substance use or prolonged opioid use are unlikely to benefit or may be excluded.

Why it matters

Potential benefit: If successful, the MTrP injection could offer a safe, easy-to-perform alternative that reduces pain and migraine burden comparable to occipital nerve block and improves quality of life.

How similar studies have performed: Prior domestic and international studies have reported that glucocorticoid injections at MTrPs can relieve pain, but direct long-term randomized non-inferiority comparisons with occipital nerve block are limited.

Eligibility criteria

Inclusion Criteria:

* Diagnosed with migraine 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.

Where this trial is running

Beijing, Beijing Municipality

• Beijing Tiantan Hospital — Beijing, Beijing Municipality, China (Recruiting)

Study contacts

• Study coordinator: Fang Luo

Conditions Myofascial Trigger Points; Chronic Migraine Headache; Greater Occipital Nerve Block