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

Jun Young Kim, Yoo Jin Choo, Min Cheol Chang

Medicine 2022 Aug 05

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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. 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. The patient was diagnosed as having a TTH. 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. 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. We believe that it can aid in reducing the procedure time and associated pain. Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Citation

Jun Young Kim, Yoo Jin Choo, Min Cheol Chang. Ultrasound-guided 5-in-1 trigger point injection for treating tension-type headache: A case report. Medicine. 2022 Aug 05;101(31):e29987