Ultrasound-guided interfascial blocks of the trapezius muscle for cervicogenic headache.

Abstract

Disorders in the cervical muscles, such as myofascial trigger points and tightness, are common factors in patients with cervicogenic headache (CEH). We aimed to evaluate the effectiveness of ultrasound-guided interfascial blocks of the trapezius muscle in patients with CEH who showed tenderness in the upper cervical muscle groups. A total of 23 patients were evaluated in the prospective observational trial. The injection was performed between the trapezius muscle and levator scapula muscle fascia with a disposable 25-gauge, 10-cm Quincke-tip spinal needle. 10 mL of 0.125% bupivacaine was injected between the muscle fascia. Numeric rating scale (NRS), neck disability index (NDI), pain frequency, and analgesic consumption in the pre-treatment and post-treatment period were evaluated. The NRS scores at 10 min, 1 week, 2 weeks, and 4 weeks after treatment were significantly better than the pre-treatment NRS score. The NDI scores at 1, 2, and 4 weeks after treatment were significantly better than the pre-treatment NDI score. The pain frequency at 1 and 2 weeks after treatment was significantly lower than that recorded in the pre-treatment period. Statistically significant reductions were observed in analgesic consumption at 1, 2, and 4 weeks after treatment, in comparison with consumption in the pre-treatment period. We suggest that an ultrasound-guided interfascial block of the trapezius muscle is effective for the treatment of CEH caused by muscle disorders.