Edward Lichten, M.D.,PC
180 East Brown Street
Birmingham, MI 48009 


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.



Most sincerely,



Edward M. Lichten, M.D.



Lichten's Pearls

There are multiple levels of cervical root involved in chronic headache.
1. Occipital nerve C2-3
2. C-6
3. Subscapularis


Treatment plan

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.