In an effort to promote a clearer understanding of the
patho-physiology of headache, migraine and occipital neuralgia, Lichten and
associates organized a national symposium in 1994 that brought together many of
the leaders in headache practice and research.
The articles from the meeting have been transcribed and
are available at no charge.
Should you have questions about anything you read, please
feel free to contact me at 248.593.9999.
Edward M. Lichten, M.D.
There are multiple levels of cervical root involved in chronic
1. Occipital nerve C2-3
1. Inject 3cc of 1% lidocaine
with 1/2cc of dexamethasone at C2-3 notch (1 inch lateral to midline)
2. Palpate the C5-6 lateral vertebrae for triggers. Usual location is
directly lateral. Inject 1cc here.
3. Palpate the supra-spinatus
(trapezoid between neck and acromion (shoulder) for tightness. One inch
from plum line of ear is the scapular notch. Tenderness there shows the
subscapularis muscles to be in spasm and fixing the scapula-shoulder
complex from moving. Injections into the subscapulais may be needed to
resolve the pain issues.