Journal Mobile Options
Table of Contents
Vol. 70, No. 1-2, 2013
Issue release date: August 2013
Eur Neurol 2013;70:95-101

Efficacy of Local Lidocaine Application on Anxiety and Depression and Its Curative Effect on Patients with Chronic Tension-Type Headache

Karadaş Ö. · Inan L.E. · Ulaş Ü.H. · Odabaşi Z.
aNeurology Service, Erzincan Military Hospital, Erzincan, and bDepartment of Neurology, Ankara Training and Research Hospital, and cDepartment of Neurology, Gülhane Military Medical Academy, Ankara, Turkey

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background: Tension-type headache (TTH) is a primary headache disorder. In this study, the efficacy of local lidocaine application on anxiety and depression and its curative effect in patients with chronic TTH was investigated. Methods: Forty-eight patients (24 local lidocaine injection, 24 local saline injection group) with chronic TTH were enrolled in our study. Injections were applied to the trigger points of the muscles that are innervated by C1-C3 and the trigeminal nerve, exit points of the fifth cranial nerve, and around the superior cervical ganglion. Each patient underwent one session every 3 days. Patients were evaluated before and 3 months after the treatment. Results: In both groups, the number of painful days in a month, visual analogue scale values, amount of analgesic use in a month, Hamilton depression score, and Hamilton anxiety score decreased after the treatment. As a result, all of the parameters were found to have improved in both groups (p < 0.05), the results were statistically significant, and the lidocaine group's response to the treatment was better than the placebo group (p < 0.001). Conclusion: Our findings suggest that local lidocaine administration can be an effective method in the treatment of chronic TTH.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Silberstein SD, Lipton RB, Goadsby PJ: Tension-type headache: diagnosis and treatment; in: Clinical Practice of Headache, ed 2. Oxford, Martin Dunitz, 2002, pp 113-128.
  2. Rasmussen BK, Jensen R, Olessen J: Impact of headache on sickness absence and utilization of medical services: a Danish population study. J Epidemiol Comm Health 1992;46:443-446.

    External Resources

  3. Jensen R, Olesen J: Initiating mechanisms of experimentally induced tension-type headache. Cephalalgia 1996;16:175-182.
  4. Evans RW, Mathew NT: Handbook of Headache, ed 2. Philadelphia, Lipincott Williams & Wilkins, 2005, pp 139-144.
  5. Fernández-de-las-Peñas C, Cuadrado ML, Arendt-Nielsen L, Simons DG, Pareja JA: Myofascial trigger points and sensitization: an updated pain model for tension-type headache. Cephalalgia 2007;27:383-393.
  6. Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R: Increased prevalence of tension type headache over a 12-year period is related to increased pain sensitivity. A population study. Cephalalgia 2006;27:145-152.
  7. Mense S: Nociception from skeletal muscle in relation to clinical muscle pain. Pain 1993;54:241-289.
  8. Zissis NP, Harmoussi S, Vlaikidis N: A randomized, double-blind, placebo-controlled study of venlafaxine XR in out-patients with tension-type headache. Cephalalgia 2007;27:315-324.
  9. Silver N: Headache (chronic tension-type). Am Fam Physician 2007;76:114-116.

    External Resources

  10. Taner D: Otonom sinir sistemi, Fonksiyonel nöroanatomi, Ankara, V. Baski. ODTÜ Geliştirme Vakfi Yayincilik ve Iletişim AŞ 2004;232-248.
  11. Netter FH: The Netter Collection of Medical Illustrations; in Emre M (ed): Otonom sinir sisteminin yapisi. Ankara, I. Baski, 2007, pp 69-90.
  12. Catterall WA, Mackie K: Local anesthetics; in Brunton LL, lazo JS, Parker KKL (eds): Goodman & Gilman's The Pharmacological Basis of Therapeutics, ed 11. New York, McGraw-Hill, 2006, pp 241-251.
  13. Kayaalp O: Lokal Anestezikler; in Kayaalp O (ed): Kayalalp Rasyonel Tedavi Yönünden Tibbi Farmakoloji, ed 10. Ankara, Hacettepe-TAŞ, 2002, pp 792-806.
  14. Simons DG, Travell JG, Simons LS: Head and Neck Pain, Travell & Simons' Myofascial Pain and Dysfunction the Trigger Point Manual, ed 2. Philadelphia, Lippincott Williams & Wilkins, 1999, pp 237-484.
  15. Drop G, Valentin-Katzorke S: Triggerpunkttherapie; in Weinschenk S (ed): Handbuch Neuraltherapie, ed 1. Munich, Urban & Fischer, 2010, pp 428-460.
  16. Fischer L: Triggerpunkte; in: Neuraltherapie nach Huneke, ed 3. Stuttgart, Hippokrates Verlag, 2007, pp 70-71.
  17. Becke H: Injektion an Nerven und Nervenaustrittspunkte; in Weinschenk S (ed): Handbuch Neuraltherapie, ed 1. Munich, Urban & Fischer, 2010, pp 541-600.
  18. Fischer L: Kopf; in: Neuraltherapie nach Huneke, ed 3. Stuttgart, Hippokrates Verlag, 2007, pp 95-107.
  19. Hausammann R: Ganglion Cervicale superius; in Weinschenk S (ed): Handbuch Neuraltherapie, ed 1. Munich, Urban & Fischer, 2010, pp 509-514.
  20. Fischer L: Ganglien Injektionen; in: Neuraltherapie nach Huneke. Stuttgart, Hippokrates Verlag, 2007, pp 77-94.
  21. Olesen J: Headache Classification Subcommittee of the International Headache Society; in Oğuzhanoğlu A (ed): Başağrisi Bozukluklarinin Uluslararasi Siniflamasi. Denizli, Türk Nöroloji Derneği Yayinlari 2.Basim. Sayi: 2. Haziran, 2005, pp 25-57.
  22. Bendsten L: Central sensitization in tension-type headache - possible pathophysiological mechanisms. Cephalalgia 2000;20:486-508.
  23. Jensen R: Peripheral and central mechanisms in tension-type headache: an update. Cephalalgia 2003;23(suppl 1):49-52.
  24. Shah JP, Phillips TM, Danoff JV, Gerber LH: An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol 2005;99:1977-1984.
  25. Venâncio Rde A, Alencar FG, Zamperini C: Different substances and dry needling injections in patients with myofascial pain and headaches. Cranio 2008;26:96-103.

    External Resources

  26. Goadsby PJ, Lipton RB, Ferrari MD: Migraine - current understanding and treatment. N Engl J Med 2002;346:257-270.
  27. Inan N, Ceyhan A, Inan L, Kavaklioglu O, Alptekin A, Unal N: C2/C3 nerve blocks and greater occipital nerve block in cervicogenic headache treatment. Funct Neurol 2001;16:239-243.

    External Resources

  28. Ashkenazi A, Blumenfeld A, Napchan U, Narouze S, Grosberg B, Nett R, DePalma T, Rosenthal B, Tepper S, Lipton RB, Interventional Procedures Special Interest Section of the American: Peripheral nerve blocks and trigger point injections in headache management - a systematic review and suggestions for future research. Headache 2010;50:943-952.
  29. Levin M: Nerve blocks and nerve stimulation in headache disorders. Tech Reg Anesth Pain Manag 2009;13:42-49.

    External Resources

  30. Sabatowski R, Huber M, Meuser T, Radbruch L: SUNCT syndrome: a treatment option with local opioid blockade of the superior cervical ganglion? A case report. Cephalalgia 2001;21:154-156.
  31. Diamond S: Muscle contraction in headache; in Dalessio DJ (ed): Wolff's Headache and Other Head Pain. New York, Oxford University Press, 1987, pp 172-189.
  32. Diamond S: Depression and headache. Headache 1983;23:122-126.

    External Resources

  33. De Benedittis G, Lorenzetti A, Pieri A: The role of stressful life events in the onset of chronic primary headache. Pain 1990;40:65-75.
  34. Bovim G, Sand T: Cervicogenic headache, migraine without aura and tension-type headache. Diagnostic blockade of greater occipital and supra-orbital nerves. Pain 1992;51:43-48.
  35. Caputi CA, Firetto V: Therapeutic blockade of greater occipital and supraorbital nerves in migraine patients. Headache 1997;37:174-179.
  36. Mays KS, North WC, Schnapp M: Stellate ganglion ‘blocks' with morphine in sympathetic type pain. J Neurol Neurosurgery Psychiatry 1981;44:189.

    External Resources

  37. Maier C: GanglionaÈre lokale Opioidanalgesie (GLOA). Stuttgart: Thieme, 1996.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50