Efficacy of Adding Greater Occipital Nerve Block to Trigger Point Injection in Patients With Neck Pain

Inclusion Criteria: * Patients aged between 18 and 65 years. * Diagnosed with myofascial pain syndrome (MPS) based on the major and minor criteria described by Travell and Simons (a diagnosis requires all 5 major and at least 1 minor criterion) * Presence of active trigger points in the upper trapezius muscle. * Patients with neck pain lasting longer than 3 months. * Pain intensity of ≥5 on the Visual Analog Scale (VAS). Exclusion Criteria: * Elderly, pediatric, pregnant, postpartum, or breastfeeding individuals; patients in intensive care; unconscious individuals; or legally incapacitated persons. * Known allergy to local anesthetics used in trigger point injection (e.g., lidocaine, bupivacaine) or to other drugs used (e.g., corticosteroids). * Patients with bleeding disorders (e.g., hemophilia, thrombocytopenia) or those currently on anticoagulant therapy. * Presence of active infection at or near the injection site, or any systemic infection; impaired skin integrity. * Patients with psychiatric disorders that may interfere with treatment response or affect study outcomes. * Patients with severe neurological or cardiovascular disorders, or with uncontrolled diabetes. * Patients with cervical disc pathologies with radiculopathy. * History of receiving shoulder injection, trigger point injection, dry needling, manual therapy, or electrotherapy within the past 3 months. * History of cervical or shoulder surgery. * Patients diagnosed with adhesive capsulitis, rotator cuff tendinopathy, or shoulder impingement syndrome. * Diagnosis of fibromyalgia. * Presence of active trigger points in other back muscles.