Fig. 121.4 Posterior cervical muscles (semispinalis and multifidi). Injection of trigger point in the right posterior cervical muscles (x). The greater occipital nerve is visualized. Anatomic landmarks are noted in addition to visualization of the left vertebral artery. Avoid the vertebral artery by injecting above or below the vertebral artery area. Aspirate prior to injection. The pain pattern is shown by stippling.