Hey, Stacy, been gone a while--been busy and too frustrated to visit. Checked back in to see how everyone was doing. My wife has also been diagnosed with occipital neuralgia--must be all the rage in Atlanta. Had an epidural (no help), a facet joint injection (no help) and a local anesthetic injection at the point of the neck where the occipital nerve leaves the spine. The latter reduced the burning pain in her neck and the back of her head, so he then (two weeks later) injected botox in three locations where the nerve leaves the skull, in an effort to block the nerve and stop the muscle spasms. This has reduced her posterior neck pain, but has done nothing for her jaw/temporal pain. The doc thinks the jaw pain is secondary to the neck pain. We think the neck pain was caused by a PT putting her in cervical traction, and that the jaw pain is caused by something in the area around the jaw/ear. The doc has never heard of Ernest Syndrome, or Shankland. And he doesn't seem to like the internet too much. Says don't believe everything you read. I told him all I know is she's still in pain. I do believe pain specialists (if you can find the right one) can help, as they seem ready to try almost anything. It just may take them a while. I ordered, and received, a back issue of Practical Pain Management magazine which has an article on ES. I'm going to bring it in next appointment for the doc to read, and if that doesn't get him to try the local in that area, I'll just roll it up and hit him over the head with it.