Objectives: Compare the effects of greater occipital nerve (GON) and sphenopalatine ganglion (SPG) blocks on headache intensity and duration, number of headache days, and disability in patients with episodic migraine. Methods: In this prospective single-blind randomized study, patients with episodic migraine were randomly divided into two groups: GON and SPG block groups. Patients received blocks once a week for 4 weeks, and once a month for 2 months. The number of headache days, the headache duration, numeric rating scale (NRS) scores, and number of acute medical treatments were assessed before the procedures and 1 month, 2 months, and 3 months after the procedures. Disability was evaluated using the migraine disability assessment (MIDAS) questionnaire at baseline and 3 months after treatment. This study protocol is registered at ClinicalTrials.gov (NCT06243874.). Results: 19 patients in the GON block group and 18 patients in the SPG block group were evaluated. Significant improvements in pain severity, headache duration, number of headache days, and the need for acute medical treatment were observed in the 1st, 2nd, and 3rd months compared to baseline in the two groups (p < 0.001). There were significant improvements in the MIDAS scores in the third month (p < 0.001). The GON block group showed a greater reduction in headache intensity, duration, number of headache days, and MIDAS scores compared to the SPG block group in the 3rd month (p < 0.001). Conclusions: GON block reduces headache duration, intensity, the number of headache days, and the need for acute medical treatment much more than SPG block in patients with episodic migraine.

Patients with various aetiology of pain who underwent erector spinae plane block at different levels were evaluated at the tertiary Algology clinic. Visual analog scale (VAS) values were recorded before the block; 30 min, two weeks, and two months after the block. Medical records of fifteen patients have been obtained. The average VAS decreased from 7 ± 1 to 5 ± 3 in the second month when compared to the values before block (p < 0.01). ESP block can be an option for chronic pain in postsurgical pain syndrome and myofascial pain management.

The aim of this study was to investigate the pain type (nociceptive or neuropathic) and neuropathic pain components in patients with acute herpes zoster (HZ). Patients with acute HZ referred to the outpatient Dermatology and Venereology clinic between January 2021 and January 2022 were retrospectively detected. The demographic data including gender and age, rash localization, pain severity, and neuropathic pain components were recorded. Pain severity and neuropathic pain components were evaluated using a Visual Analog Scale (VAS) and Douleur Neuropathique 4 (DN4), respectively. The study included a total of 58 patients, comprising 33 females and 25 males. Of these patients, 35 (60.3%) were found to have neuropathic pain. Itching, burning, pins and needles, and tingling were the most frequently reported neuropathic pain signs and symptoms. The proportion of female patients with neuropathic pain was found to be significantly higher than that of male patients (p=0.021). No significant differences were observed in the distribution of pain across different body sites or in the age of patients with neuropathic pain (p>0.05). Itching was significantly more common in younger patients (p=0.02). In conclusion, the study found that over half of the patients with acute HZ experienced neuropathic pain, and this was more frequently observed in female patients. Analysis of different components of neuropathic pain showed significant differences in age, gender, and site distribution. The findings of this study may have important implications for the manage-ment and treatment of acute HZ.

Objective: To compare the efficiency of unilateral and bilateral transforaminal epidural steroid injections (TFESI) in patients with unilateral lumbar disc herniation (LDH). Methods: In this prospective randomized single-blinded study, patients with unilateral LDH were randomly divided into two groups: A unilateral TFESI group; and a bilateral TFESI group. The severity of pain and disability were assessed with the Numeric Rating Scale (NRS-11) and Oswestry Disability Index (ODI) at baseline, 1 week, 1 month, and 3 months after interventions. Treatment response was defined as ≥50% reduction in the NRS-11 at the 3-month follow-up. Changes in medication consumption at 3 months following the interventions were recorded. This study protocol is registered at ClinicalTrials.gov (NCT06240793). Results: A total of 104 patients were included in the study (n = 58 in the unilateral TFESI group and n = 46 in the bilateral TFESI group). The NRS-11, ODI scores and medical treatment consumption did not differ statistically between the groups at 3 months (p ˃ 0.05). At 3 months, the rates of patients with a > 50% decrease in NRS-11 scores were 13.8% and 32.6% in the unilateral TFESI group and bilateral TFESI group, respectively. Conclusions: Unilateral and bilateral TFESI both decrease pain severity and disability scores to a similar degree, although bilateral TFESI was more effective in reducing pain severity by over 50% in patients with single-level unilateral LDH.