Purpose: To evaluate C2/C3 nerve blocks and greater occipital nerve (GON) block in treatment of cervicogenic headache in patients referring to pain clinic of Amir Alam hospital.

Method: In this retrospective cohort, records of 58 patients with cervicogenic headache presenting to pain clinic of Amir Alam hospital during 2013were evaluated. The anesthetic blockade procedure was performed on C2/3 facet joint or greater occipital nerve (GON). Then the patient’s headache relief after the treatment as a percentage of pretreatment headache, or by recording the difference between pre- and post-procedure headache intensity, as measured using a numeric rating scale (NRS) were compared.

Results: 58 patients mean age 41.56±10.24, mean duration of pain about 8.40±6.35 years were evaluated. The immediate response more than 50% to blocking in C2/C3 group was slightly more than GON group (18 patients vs 17) but the difference was not significant (P=0.54). NRS before and 1 week and 1month after treatment significantly decreased in both groups (P=0.001). Regarding NRS the difference between two groups 1 week after procedure was significant (P=0.01) but was not significant after 1 month (P=0.78). The pain reduction(frequency ) one week after blocking in C2/C3 group was significantly more than GON group(53.79±19.71 vs 67.58±23.85,P=0.02),but 1month after blocking in C2/C3 group was less than GON group, the difference was not significant(33.10±19.65 vs 31.72±24.79,P=0.81).

Conclusion: this cohort study indicate C2, C3 and greater occipital nerve (GON) are effective techniques for cervicogenic headache relief in short term. Moreover we detected C2/C3 blocks are significantly more effective than GON in short term.