Ultrasound-guided 5-in-1 trigger point injection for treating tension-type headache: A case report.

ABSTRACT:

Rationale

Tension-type headache (TTH) is the most common type of primary headache, and trigger point injection (TPI) is frequently used for controlling pain originating from TTHs. In the current report, we introduce a TPI technique involving 4 neck muscles (upper trapezius, splenius capitis, semispinalis capitis, and inferior oblique capitis) and a greater occipital nerve (GON) block within the same sonographic view for the treatment of TTHs.

Patient concerns

A 44-year-old woman complained with pressing and tightening, nonpulsating, recurrent headaches, mainly in the bilateral occipital area, lasting for approximately 6 months (numeric rating scale: 5). The patient had no nausea, vomiting, photophobia, or phonophobia.

Diagnoses

The patient was diagnosed as having a TTH.

Interventions

Under ultrasound (US) guidance, a mixed solution of 2 mL of 2% lidocaine and 5 mL of normal saline was injected layer-by-layer into the 4 target muscles of the neck (upper trapezius, splenius capitis, semispinalis capitis, and inferior oblique capitis) and near the right GON within the same sonographic view bilaterally.

Outcomes

Two- and 4-week follow-ups after administration of the injections revealed no headache. Our US-guided 5-in-1 TPI technique is viable for treating patients with TTH.

Lessons

We believe that it can aid in reducing the procedure time and associated pain.

SUBMITTER: Kim JY 

PROVIDER: S-EPMC9351843 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature