The aim of this pilot study was to compare the efficacy of pulsed radiofrequency to the greater occipital nerve versus a greater occipital
nerve block with a mixture of local anaesthetic and
steroid in the management of refractory
cervicogenic headache. We enrolled 30 patients suffering from refractory
cervicogenic headache. Patients were randomly allocated into two groups of fifteen. A greater occipital
nerve block with
steroid was utilised in group A, while a
pulsed radiofrequency treatment was employed in group B. Success of both procedures was evaluated by comparing pre and post intervention Visual Analogue Scale of
pain, Medication Quantification Scale - III. and Global Perceived Effect at three and 9 months after the procedures. At three months post
therapy a significant decrease in Visual Analogue Scale (p<0.001) was identified (3.2 points in group A, 3.3 points in group B respectively). In group B
pain remained reduced even after 9 months (p<0.001) when compared to pre treatment scores. The consumption of
analgesic medication was reduced significantly in both groups at three months (p<0.001) and 9 months (p<0.01), respectively. No serious complication was noted. Greater occipital
nerve block is a safe, efficient technique in the management of
cervicogenic headaches. Despite the lack of high quality scientific evidence (level III or IV) in the literature, we have extensive experience with
steroid application and pulsed radiofrequency to the greater occipital nerve and report the beneficial results in our study.