Effectiveness of Third Occipital Nerve Pulsed Radiofrequency in Cervicogenic Headache
Evaluation of the Effectiveness of Third Occipital Nerve Pulsed Radiofrequency Treatment in Patients With Cervicogenic Headache
Ankara City Hospital Bilkent
25 participants
Feb 1, 2026
INTERVENTIONAL
Conditions
Summary
Cervicogenic headache is a secondary headache disorder originating from cervical spine structures and is frequently associated with chronic pain, functional limitation, and impaired quality of life. The third occipital nerve, which innervates the C2-3 zygapophyseal joint, plays an important role in the pathophysiology of cervicogenic headache. Pulsed radiofrequency is a minimally invasive interventional pain management technique that modulates nociceptive transmission without causing permanent neural damage. Although third occipital nerve pulsed radiofrequency is increasingly used in clinical practice, prospective data evaluating its clinical effectiveness and safety remain limited. The aim of this prospective, single-center study is to evaluate the effectiveness and safety of ultrasound-guided third occipital nerve pulsed radiofrequency treatment in patients diagnosed with cervicogenic headache. Pain intensity, headache characteristics, analgesic consumption, and patient-reported outcomes will be assessed before treatment and during follow-up. The results of this study are expected to contribute to clinical evidence supporting interventional treatment strategies for cervicogenic headache.
Eligibility
Inclusion Criteria7
- Age 18 years or older
- Diagnosis of cervicogenic headache according to the International Classification of Headache Disorders, 3rd edition (ICHD-3)
- Availability of cranial and cervical spine imaging
- At least 5 headache days per month
- Inadequate response to pharmacological and/or physical therapy treatments
- Ability to understand and provide written informed consent
- Positive response to ultrasound-guided diagnostic third occipital nerve block, defined as at least 50% reduction in pain intensity or patient-reported meaningful improvement
Exclusion Criteria16
- Secondary headache disorders other than cervicogenic headache according to ICHD-3
- Signs or symptoms of cervical nerve root irritation and/or spinal stenosis
- Sensory deficit in the greater occipital nerve dermatome
- Cranio-cervical structural defects or anatomical abnormalities at or near the target site
- Local or systemic infection
- Non-pharmacological headache treatment within the last 3 months (e.g., physical therapy, botulinum toxin A, acupuncture, ozone therapy, cognitive behavioral therapy)
- Pregnancy or suspected pregnancy
- Known allergy to local anesthetic agents
- History of malignancy
- Known organic disease of the brain or spinal cord
- History of cranial or cervical surgery within the last 12 months
- Bleeding or coagulation disorders or use of oral anticoagulant therapy
- Comorbid conditions that may cause headache (e.g., uncontrolled hypertension, intracranial lesions)
- Conditions that may interfere with treatment adherence or outcome assessment (e.g., psychiatric disorders, dementia)
- Request for re-treatment due to development of contralateral pain or other pain conditions during follow-up
- Refusal to undergo the intervention or withdrawal of consent at any stage of the study
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Interventions
Ultrasound-guided pulsed radiofrequency treatment applied to the third occipital nerve at the C2-3 zygapophyseal joint level for the management of cervicogenic headache.
Locations(1)
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NCT07366060