Regional Head and Face Pain Relief Following Lower Cervical Intramuscular Anesthetic Injection

• Published in: Headache Vol. 43; no. 10; pp. 1109 - 1111
• Main Authors: Mellick, Gary A., Mellick, Larry B.
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148 , USA Blackwell Science Inc 01-11-2003; Blackwell
• Subjects: Adult; Aged; Anesthetics, Local - administration & dosage; Biological and medical sciences; Bupivacaine - administration & dosage; cephalgia; cervical injection; Cervical Vertebrae; Chronic Disease; Facial Neuralgia - drug therapy; facial pain; Female; headache; Headache Disorders - drug therapy; Humans; IHS classification; Injections, Intramuscular - methods; Male; Medical sciences; Middle Aged; migraine; Migraine Disorders - drug therapy; Neurology; neurovascular headache; postherpetic neuralgia; Tension-Type Headache - drug therapy; trigeminal neuralgia; Trigeminal Neuralgia - drug therapy; trigeminovascular system; Vascular diseases and vascular malformations of the nervous system; Headache; Nervous system diseases; Head; migraine; facial pain; neurovascular headache; Cerebral disorder; cervical injection; IHS classification; Pain; cephalgia; trigeminal neuralgia; Central nervous system disease; postherpetic neuralgia; Neurological disorder; trigeminovascular system; Cerebrovascular disease
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1046/j.1526-4610.2003.03214.x

Background.—Although cervical trigger point intramuscular injections are commonly used to relieve localized neck pain, regional head pain relief from lower cervical paravertebral injections has not been reported previously.
Purpose.—To evaluate the safety and efficacy of such injections in a selected group of patients with intractable head or face pain.
Methods.—In a series of patients with chronic head or face pain, local anesthetic was injected into the lower cervical spine paravertebral musculature approximately 1 to 2 inches lateral to the seventh cervical spinous process.
Results.—In addition to producing rapid relief of palpable scalp or facial tenderness (mechanical hyperalgesia and allodynia pain), this lower cervical intramuscular injection technique alleviated associated symptoms of nausea, photophobia, and phonophobia in patients with migrainous headache.
Conclusion.—Our results suggest that lower cervical intramuscular anesthetic injection may be an effective treatment for head or face pain.