Ultrasound-guided interfascial blocks of the trapezius muscle for cervicogenic headache: a report of two cases

Abstract

Cervicogenic headache (CEH) is a headache arising from cervical nociceptive structures such as facet joints, disci intervertebrales, muscles and ligaments. Myofascial trigger points (TrPs) are common factors in patients with CEH and contribute to the pain and disability. In this report, we present two patients with CEH who had TrPs in their upper trapezius muscles. Each patient received an ultrasound-guided interfascial block of the trapezius muscle. Case 1 A 79-year-old female patient presented with a complaint of headache due to trigger point in her upper trapezius muscle. Her Numerical Rating Scale (NRS) score for pain intensity was 10. We performed an ultrasound-guided interfascial block of the trapezius muscle. Her NRS score at 30 minutes after the procedure was 2. The patient was pain free during the two months follow-up period. Case 2 A 55-year-old female patient presented with a complaint of headache due to trigger point in her upper trapezius muscle. Her Numerical Rating Scale (NRS) score for pain intensity was 8. We performed an ultrasound-guided interfascial block of the trapezius muscle. Her NRS score at 30 minutes after procedure was 3. The patient was pain free during the two weeks follow-up period. The structure of the fascia can ease diffusion of an injected anaesthetic during diagnostic and therapeutic blocks, and interfascial injections are becoming more common. We suggest that this treatment may produce positive effects for patients with CEH caused by trigger points.