• migraine;
  • headache;
  • cephalgia;
  • IHS classification;
  • trigeminovascular system;
  • cervical injection;
  • neurovascular headache;
  • facial pain;
  • postherpetic neuralgia;
  • trigeminal neuralgia

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.