Regional head and face pain relief following lower cervical intramuscular anesthetic injection.
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.


OBJECTIVE
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.


CONCLUSIONS
Our results suggest that lower cervical intramuscular anesthetic injection may be an effective treatment for head or face pain.
Mellick
Gary A
GA
American Pain Specialists, Inc, Grafton, Ohio 44044, USA.
Mellick
Larry B
LB
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002574:Cervical Vertebrae; D002908:Chronic Disease; D005156:Facial Neuralgia / Q000188:drug therapy*; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy*; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy; D018781:Tension-Type Headache / Q000188:drug therapy; D014277:Trigeminal Neuralgia / Q000188:drug therapy
D000779:Anesthetics, Local; D002045:Bupivacaine