Interventional Techniques for the Treatment of Primary Headaches: a Systematic Review and Meta-analysis

Evaluate the effectiveness of different interventional procedures for the treatment of primary headaches in reducing pain intensity and frequency of painful episodes, performing a systematic review and meta-analysis. We performed this review and meta-analysis according to the Cochrane Collaboration and PRISMA-P guidelines for the development of systematic review protocols. We reviewed randomized clinical trials that compared interventional techniques to treat headaches compared with placebo or pharmacological treatment among adults. In patients with migraine, a greater occipital nerve (GON) block significantly reduced pain intensity (MD = − 0.93, 95% CI = − 1.75, − 0.11; p = 0.03). Interventional techniques performed for tension-type headache (TTH) significantly reduced pain intensity (MD = − 2.34, 95% CI = − 3.30, − 1.37, p < 0.00001). Stellate ganglion block significantly reduced pain intensity in patients suffering from facial pain associated with different causes (MD = − 2.94, 95% CI = − 4.57, − 1.32, p = 0.0004). GON blocks reduce pain intensity in migraine, tension-type headache, and cervicogenic pain. Trigger point injection significantly reduced pain intensity in tension-type headache, and stellate ganglion block effectively reduced facial pain intensity. Most of the outcomes had a high heterogeneity.