The Effect of Methylprednisolone Acetate Injection at Cervical Trigger Points in Chronic as well as Drug Resistant Headache

  • Mohammadjavad Hadianfard Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Abbas Rahimi-Jaberi Assistant Professor, Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Shahrbanoo Kazemilar Physiatrist, Shiraz, Iran
Keywords: Headache; Methylprednisolone; Injection


Background: Most adults have experienced a headache at least once. A high percentage of these headaches originate in cervical structures, such as neck muscles, known as cervicogenic headache (CGH). This study aimed to assess the efficacy of injection of methylprednisolone acetate at the Gallbladder 20 (GB-20) acupuncture points in muscle originated, chronic, and drug resistant headaches.

Methods: In this randomized clinical trial conducted at Shiraz University of Medical Sciences, Shiraz, Iran, in 2009-2010, 25 patients with both chronic and drug resistant CGH and cervical muscle tender points underwent methylprednisolone acetate injection. To evaluate the severity of these patients' headache, the visual analogue scale (VAS) was used. The collected data were analyzed using Wilcoxon test in SPSS software.

Results: The patients’ mean headache intensity on the VAS before the injection was 7.76 ± 2.30. This value was 2.60 ± 2.90, 30 days after the injection. The values at 1 and 3 months post-procedure were 3.52 ± 3.30 and 3.48 ± 3.50, respectively. In other words, a statistically significant reduction was observed in the pain score (P < 0.001). The frequency of headache attacks 1 and 3 months after the injection decreased 72% and 76% among patients, respectively. Average duration of headache attacks, 1 month and 3 months after the injection, decreased in 72% of patients.

Conclusion: Injection of methylprednisolone acetate at the GB-20 acupuncture points in muscle originated CGH could be used as an appropriate therapy with significant therapeutic efficacy only when injected once.


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