Research published at national meeting, American Academy of Pain Medicine, 27th Annual Scientific Meeting, National Harbor, Maryland

Below is a summary of our research presented March 24-27, 2011, at the 27th Annual Scientific Meeting of the American Academy of Pain Medicine, National Harbor, Maryland. The study was done jointly by Dr. Campa and Dr. Larison over the last three years. Dr. Campa was on-site to present our findings. This research should help other physicians more accurately diagnose and treat those patients who present with head and face pain.

John A. Campa III, MD
Tom C. Larison, DC
July 31, 2011
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The Value Of High Cervical EMG In Patients With Non-migrainous Persistent Head Pain

J. A. Campa III, MD, T. C. Larison, DC, Pain Diagnosis Consultants, LLC, Albuquerque, NM; Faculty, School of Medicine, University of New Mexico, Albuquerque, NM.

BACKGROUND: Non-migrainous, persistent head pain presents a special challenge to the diagnostician, as both intra- and extra-cranial etiologies must be considered. The high cervical electromyogram (HC-EMG), in its assessment of the relevant cervical musculature and paraspinal muscles [C2, C3, C4, Sternocleidomastoid (C2, C3; CN-11), Trapezius (C3, C4; CN-11)], would assist in resolving the primary pain generator.

AIM: To assess the value of HC-EMG in identifying extra-cranial potential pain generators in non-migrainous, persistent head pain.

METHODS: 30-month retrospective chart review; 24 patients underwent HC-EMG; excluding migraine/migraine-like presentations. Results correlated with clinical findings, and where available, X-ray, CT, MRI lesions at C1-2, C2-3, C3-4 (disc bulge, protrusion, extrusion, disc osteophyte complex, listhesis, foraminal/recess narrowing, root/cord impingement, thecal sac effacement, canal stenosis).

RESULTS: Abnormal HC-EMG: 14/24 (58.3%); Abnormal HC-EMG, with neuroimaging available: 11/14 (78.6%); Abnormal HC-EMG, with correlating neuroimaging: 7/11 (63.6%); Acute root findings: C2(2), 25%; C3(4) 50%; C4(2), 25%; Chronic root findings: C2(5), 25%; C3(8), 40%; C4(7), 35%; Pain location: Abnormal HC-EMG - Occipital(14), 100%;

CONCLUSIONS: We conclude that the HC-EMG, is a valuable diagnostic tool in the assessment of non-migrainous, persistent head pain of extra-cranial origin. We recommend its routine use in the evaluation of occipital head pain, particularly in patients with known high cervical spinal segmental lesions at the C2-3 level.