Efficacy of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients With Neck Pain

Exclusion Criteria

• •Elderly, pediatric, pregnant, postpartum, or breastfeeding individuals; patients in intensive care; unconscious individuals; or legally incapacitated persons.
• •Known allergy to local anesthetics used in trigger point injection (e.g., lidocaine, bupivacaine) or to other drugs used (e.g., corticosteroids).
• •Patients with bleeding disorders (e.g., hemophilia, thrombocytopenia) or those currently on anticoagulant therapy.
• •Presence of active infection at or near the injection site, or any systemic infection; impaired skin integrity.
• •Patients with psychiatric disorders that may interfere with treatment response or affect study outcomes.
• •Patients with severe neurological or cardiovascular disorders, or with uncontrolled diabetes.
• •Patients with cervical disc pathologies with radiculopathy.
• •History of receiving shoulder injection, trigger point injection, dry needling, manual therapy, or electrotherapy within the past 3 months.
• •History of cervical or shoulder surgery.
• •Patients diagnosed with adhesive capsulitis, rotator cuff tendinopathy, or shoulder impingement syndrome.
• •Diagnosis of fibromyalgia.
• •Presence of active trigger points in other back muscles.