Third occipital nerve pulsed radiofrequency for cervicogenic headache

Evaluation of the Effectiveness of Third Occipital Nerve Pulsed Radiofrequency Treatment in Patients With Cervicogenic Headache

NA · Ankara City Hospital Bilkent · NCT07366060

This trial will test whether ultrasound-guided pulsed radiofrequency of the third occipital nerve reduces pain in adults with cervicogenic headache who responded to a diagnostic nerve block.

Quick facts

PhaseNA
Study typeInterventional
Enrollment25 (estimated)
Ages18 Years and up
SexAll
SponsorAnkara City Hospital Bilkent (other)
Locations1 site (Ankara, Ankara)
Trial IDNCT07366060 on ClinicalTrials.gov

What this trial studies

Cervicogenic headache arises from cervical spine structures, particularly the C2-3 zygapophyseal joint innervated by the third occipital nerve. This prospective, single-center, open-label interventional study at Ankara City Hospital Bilkent enrolls adults meeting ICHD-3 criteria who show a positive response to an ultrasound-guided diagnostic third occipital nerve block. Eligible participants receive ultrasound-guided pulsed radiofrequency of the third occipital nerve at the C2-3 level using standard protocols, with outcomes measured by pain intensity (VAS), headache frequency, analgesic consumption, and patient-reported measures at predefined follow-up visits. Safety and procedure-related adverse events are monitored throughout the study period.

Who should consider this trial

Good fit: Adults (≥18 years) diagnosed with cervicogenic headache by ICHD-3, with at least 5 headache days per month, inadequate response to conservative therapy, and who achieved ≥50% pain relief or meaningful improvement after an ultrasound-guided diagnostic third occipital nerve block are ideal candidates.

Not a fit: Patients with other secondary headache disorders, signs of cervical nerve root irritation or spinal stenosis, cranio-cervical structural abnormalities, active infection, recent non-pharmacological headache treatments, or who did not have a positive diagnostic block are unlikely to benefit.

Why it matters

Potential benefit: If successful, the procedure could provide longer-lasting pain relief, reduce headache frequency, and decrease the need for pain medications without causing permanent nerve damage.

How similar studies have performed: Pulsed radiofrequency applied to occipital nerves and cervical facet-related pain has shown promising results in case series and small trials, but prospective data specifically for third occipital nerve PRF remain limited.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age 18 years or older
* Diagnosis of cervicogenic headache according to the International Classification of Headache Disorders, 3rd edition (ICHD-3)
* Availability of cranial and cervical spine imaging
* At least 5 headache days per month
* Inadequate response to pharmacological and/or physical therapy treatments
* Ability to understand and provide written informed consent
* Positive response to ultrasound-guided diagnostic third occipital nerve block, defined as at least 50% reduction in pain intensity or patient-reported meaningful improvement

Exclusion Criteria:

* Secondary headache disorders other than cervicogenic headache according to ICHD-3
* Signs or symptoms of cervical nerve root irritation and/or spinal stenosis
* Sensory deficit in the greater occipital nerve dermatome
* Cranio-cervical structural defects or anatomical abnormalities at or near the target site
* Local or systemic infection
* Non-pharmacological headache treatment within the last 3 months (e.g., physical therapy, botulinum toxin A, acupuncture, ozone therapy, cognitive behavioral therapy)
* Pregnancy or suspected pregnancy
* Known allergy to local anesthetic agents
* History of malignancy
* Known organic disease of the brain or spinal cord
* History of cranial or cervical surgery within the last 12 months
* Bleeding or coagulation disorders or use of oral anticoagulant therapy
* Comorbid conditions that may cause headache (e.g., uncontrolled hypertension, intracranial lesions)
* Conditions that may interfere with treatment adherence or outcome assessment (e.g., psychiatric disorders, dementia)
* Request for re-treatment due to development of contralateral pain or other pain conditions during follow-up
* Refusal to undergo the intervention or withdrawal of consent at any stage of the study

Where this trial is running

Ankara, Ankara

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Cervicogenic Headache, Third Occipital Nerve, cervicogenic headache, Pulsed Radiofrequency, TON PRF

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.