Headache, Rheumatoid Arthritis
Conditions
Brief summary
Rheumatoid arthritis is a common type of autoimmune arthritis that is characterized by inflammation of the synovial membranes. Even though any joint can be affected by the disease, cervical spine is often affected, and cervical pain is reported by 40-88% of RA patients, Cervical spine involvement is a feature of long-lasting disease, where atlantoaxial impaction with odontoid process vertical subluxation through the foramen magnum being one of the greatest and dangerous complications
Detailed description
To our knowledge the effectiveness of 3rd occipital nerve blocks in managing chronic upper neck pain, headache in RA patients is not measured yet, so we aimed at assessing the the effectiveness of 3rd occipital nerve blocks in headache management in RA patients who used other medical agents and to compare the results with those of the patients who used only 3rd occipital nerve pulsed radiofrequancy on clinical and radiographic bases.
Interventions
DRUGRadiofrequency
), received bilateral 3rd occipital nerve RF under fluoroscopic guidance. Levobupivacaine (0.3 mL; 0.75%) and triamcilonone (1 mg) were injected at each level
DRUGSteroids
received systemic steroids oral prednisolone tablet, 10 mg/day
Sponsors
Assiut University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
To our knowledge the effectiveness of 3rd occipital nerve blocks in managing chronic upper neck pain, headache in RA patients is not measured yet, so we aimed at assessing the the effectiveness of 3rd occipital nerve blocks in headache management in RA patients who used other medical agents and to compare the results with those of the patients who used only 3rd occipital nerve pulsed radiofrequancy on clinical and radiographic bases.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* patients suffering from upper neck pain and/or headache due to bilateral 3rd occipital nerve involvement evidenced by magnetic resonance imaging (MRI).
Exclusion criteria
* disc herniation with radicular pain, * symptomatic spinal stenosis, * surgical interventions of the cervical spine within the last 3 months, * uncontrolled major depression or psychiatric disorders, * heavy opioid usage
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| neck disability index score | 6 months | maximum score = 50 worst paint , lowest score = no pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severity of headache Visual analog scale | 6 months | maximum scale= 100 worst paint , lowest scale = no pain |
Countries
Egypt
Outcome results
None listed