Personalized Pulsed Radiofrequency of the Greater Occipital Nerve for Medication Overuse Headache
Individualized Application of Occipital Nerve Pulsed Radiofrequency in Medication Overuse Headache: A Randomized Controlled Evaluation
Ankara City Hospital Bilkent
90 participants
Jan 26, 2026
INTERVENTIONAL
Conditions
Summary
This study evaluates a novel treatment approach for medication overuse headache (MOH) using greater occipital nerve pulsed radiofrequency (GONPRF). Three treatment strategies are compared: Standard Treatment: Limitation of overused acute headache medications, lifestyle counseling, and continuation of existing preventive medications. Primary GONPRF: GONPRF administered in addition to standard treatment. Modified GONPRF: GONPRF administered as a second-line intervention in individuals who do not respond adequately to standard treatment alone. The study assesses whether GONPRF, when applied early or after an initial period of standard care, reduces monthly headache days more rapidly and effectively than standard treatment alone. Outcomes are evaluated over a 6-month follow-up period using headache diaries and scheduled clinical assessments. This is a randomized controlled trial designed to systematically evaluate the clinical benefit of GONPRF in patients with medication overuse headache.
Eligibility
Inclusion Criteria7
- Age 18-65 years
- Diagnosed with Medication Overuse Headache (MOH) according to ICHD-3 criteria
- No laboratory evidence of bleeding or clotting disorders
- No active infection
- Not pregnant and no suspicion of pregnancy
- No history of craniocervical surgery that may alter anatomical structures at the intervention site
- Able to understand the study procedures, provide written informed consent, and comply with treatment
Exclusion Criteria6
- Changes in preventive treatment for migraine and/or tension-type headache within the last 3 months
- Severe systemic disease (e.g., uncontrolled diabetes, serious cardiovascular disease, malignancy)
- Psychiatric disorders (including current antidepressant use or psychiatric follow-up)
- History of alcohol or substance abuse
- Pregnancy, breastfeeding, or plans for pregnancy in the next 12 months
- Concurrent use of other prophylactic headache treatments
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Interventions
GONPRF applied at C2 under ultrasound guidance in addition to standard care, starting at enrollment. Follow-up at 1, 3, and 6 months.
Limitation of overused acute headache medications, lifestyle advice (nutrition, hydration, activity, sleep), and continuation of preventive medications. Participants who respond at 1 month continue standard care.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07360782