Greater Occipital Nerve Block Alone Versus Dual Nerve Block in Cervicogenic Headache and Occipital Neuralgia

Adults aged 18 to 65 years Clinical diagnosis of cervicogenic headache (CEH) and/or occipital neuralgia (ON) according to ICHD-3 criteria Pain duration of more than 3 months Pain localized to the occipital region, consistent with the distribution of the greater and/or lesser occipital nerves Inadequate response to conservative therapy (e.g., analgesics, physiotherapy) Willingness to participate and provide written informed consent Exclusion Criteria: Previous nerve block or other interventional procedures for headache Use of systemic corticosteroids within the past 3 months Known allergy to lidocaine or other amide-type local anesthetics Evidence of secondary causes of headache on imaging (e.g., tumor, infection) Pregnancy or breastfeeding Active infection at the injection site Coagulopathy or use of anticoagulant therapy Significant psychiatric or neurological comorbidities interfering with study participation