Effect of Ultrasound-Guided Dry Needling Targeting Rectus Capitus Posterior Major on Individuals With Headaches
Texas Tech University Health Sciences Center
50 participants
Mar 1, 2026
INTERVENTIONAL
Conditions
Summary
Headaches such as tension-type, migraine, and cervicogenic (neck-related) headaches are among the most common and disabling conditions worldwide. and are often associated with tight or sensitive muscles at the base of the skull, which can contribute to headaches. Dry needling involves inserting a very thin, sterile needle into tight muscle areas known as trigger points to relieve pain and muscle tension. When applied to the deep neck muscles, including those beneath the skull, dry needling may reduce headache symptoms. The suboccipital region contains important structures such as the vertebral artery, greater occipital nerve, and spinal cord, which requires precise needle placement to maintain safety. Many needling techniques used in this region have not been validated for accuracy or safety in living subjects. This study will use real-time ultrasound imaging to guide dry needling of the rectus capitis posterior major muscle and directly visualize nearby structures to minimize risk. The main goals of this research are to examine the effects of a single session of ultrasound-guided dry needling on headache symptoms and to confirm the safety, accuracy, and consistency of the proposed needling technique using ultrasound imaging.
Eligibility
Inclusion Criteria4
- Reports of a headache within the last 6 months (no minimum or maximum frequency or duration)
- Current reports of headache
- Tenderness to palpation of suboccipital muscles with Numeric Pain Rating Scale score ≥ 2/10
- No history of cervical spine surgery or neurological disorders
Exclusion Criteria11
- History of cervical spine trauma or surgery
- Diagnosed bleeding disorder
- Currently using anticoagulant medications
- Currently using anti-platelet medications
- Diagnosed systemic joint diseases such as rheumatoid arthritis
- Active infection
- Diabetes
- Cancer
- Fibromyalgia
- Cervical radiculopathy
- Inability to tolerate prone positioning for the duration of the procedure.
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Interventions
Each subject will receive two separate dry needle insertions targeting the rectus capitus posterior major. Method 1 will be 30 degrees (relative to the frontal plane) insertion angle toward the occiput. Method 2 will be 45 degrees (relative to the frontal plane) insertion angle toward the occiput.
Locations(1)
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NCT07309874