Ultrasound-Guided Ablation for Neuropathic Pain

Overseen By Manuel Clark

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Kansas Medical Center

Disqualifiers: Unstable condition, Pregnant, Pacemaker, Craniotomy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 1 day

20 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants must have tried and not found relief from oral medications like NSAIDs, opioids, and anticonvulsants.

What data supports the effectiveness of the treatment Ultrasound Guided Radiofrequency Ablation of the Occipital Nerve for neuropathic pain?

Research shows that using ultrasound to guide radiofrequency ablation of the greater occipital nerve can provide significant and lasting pain relief for conditions like occipital neuralgia and chronic migraines, which are similar to neuropathic pain. In reported cases, patients experienced immediate and continued pain relief for several months after the treatment. ^{1 2 3 4 5}

Is ultrasound-guided ablation for neuropathic pain safe?

Ultrasound-guided procedures, like nerve blocks and radiofrequency ablation, are generally considered safe with few localized side effects, though rare complications like infections can occur if proper techniques aren't followed. Studies have shown that these procedures can provide significant pain relief, but more research is needed to fully understand their safety compared to traditional methods. ^{1 3 6 7 8}

How is ultrasound-guided radiofrequency ablation for occipital nerve pain different from other treatments?

Ultrasound-guided radiofrequency ablation for occipital nerve pain is unique because it uses ultrasound to precisely guide the treatment, which can improve accuracy and effectiveness compared to traditional methods. This approach is particularly beneficial for patients who do not respond well to standard treatments, offering significant and lasting pain relief. ^{1 2 3 9 10}

What is the purpose of this trial?

Study an ultrasound guided approach to radiofrequency ablation of the occipital nerve that makes it possible to see the needle during treatment procedure. It is hoped this will reduce the amount of pain after the standard of care procedure.

Eligibility Criteria

This trial is for adults aged 18-80 with occipital neuralgia or migraines in the occipital region, experiencing headaches at least 10 days a month. They must have tried and not responded well to NSAIDs, opioids, and anticonvulsants. Diagnosis should meet ICHD criteria including specific pain patterns and temporary relief from local anesthetic blocks.

Inclusion Criteria

I have been diagnosed with occipital neuralgia as per ICHD guidelines.

I have tried and found no relief from pain with NSAIDs, opioids, and anticonvulsants.

I have migraines, mainly in the back of my head, that got better with a specific nerve treatment.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo ultrasound-guided radiofrequency ablation of the occipital nerve

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

18 months

Treatment Details

Interventions

• Ultrasound Guided Radiofrequency Ablation of the Occipital Nerve

Trial Overview The study tests an ultrasound-guided method for radiofrequency ablation on the occipital nerve, aiming to visualize the needle during treatment to potentially reduce post-procedure pain compared to standard care.

Participant Groups

Group I: Ultrasound Guided Approach Experimental Treatment 1 Intervention

Ultrasound-guided approach to occipital nerve radiofrequency ablation

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials

527

Recruited

181,000+

Findings from Research

Occipital nerve block is generally considered a safe and effective treatment for occipital neuralgia and other headache types, but there is a risk of complications, as demonstrated by a case of epidural abscess occurring 16 days post-procedure.

This case highlights the critical need for strict aseptic techniques during the procedure to minimize infection risks, reminding clinicians to be vigilant about potential complications even in otherwise healthy patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report. Christie, SD., Kureshi, N., Beauprie, I., et al.[2022]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Ultrasound-guided greater occipital nerve blocks and pulsed radiofrequency ablation for diagnosis and treatment of occipital neuralgia. [2022]

2. Italy pubmed.ncbi.nlm.nih.gov

Efficacy of ultrasound-guided greater occipital nerve pulsed radiofrequency therapy in chronic refractory migraine. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Feasibility study of greater occipital nerve blocks by focused ultrasound - an animal study. [2022]

4. England pubmed.ncbi.nlm.nih.gov

A case of pulsed radiofrequency lesioning for occipital neuralgia. [2022]

5. Germany pubmed.ncbi.nlm.nih.gov

Greater occipital nerve infiltration under MR guidance: Feasibility study and preliminary results. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Occipital osteomylelitis and epidural abscess after occipital nerve block: A case report. [2022]

7. Korea (South) pubmed.ncbi.nlm.nih.gov

Feasibility of Ultrasound Guided Atlanto-occipital Joint Injection. [2021]

8. Turkey pubmed.ncbi.nlm.nih.gov

Ultrasound-Guided Bilateral Greater Occipital Nerve Block for Mass Excision. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Occipital Neuralgia Diagnosis and Treatment: The Role of Ultrasound. [2017]

10. France pubmed.ncbi.nlm.nih.gov

[Ultrasound evaluation of the greater occipital nerve]. [2019]