Caring for Face Pain and Sleep Apnea
Rich Hirschinger, DDS, MBA
Diplomate American Board of Orofacial Pain
9615 Brighton Way, Suite 323
Beverly Hills, CA 90210
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EC-Spray-Pattern.gifEthyl Chloride Spray Pattern for the Head and Neck

More About Myofascial Pain

Ethyl chloride is a prescription medication that Dr. Hirschinger uses, in his Beverly Hills facial pain and headache practice, as a topical skin refrigerant to reduce head and neck muscle pain. It is a liquid but once it hits the skin, it evaporates. A great aspect to ethyl chloride is that it can greatly reduce head and neck muscle pain for several hours even though it is applied topically.

Ethyl chloride comes in a bottle and a can. Dr. Hirschinger strongly prefers the bottle in the medium jet spray since it is colder than the can. Here are the directions:Ethyl-chloride.png

  • Hold the bottle 12-18 inches away from the skin.
  • Hold the bottle upside down on an angle so that the liquid flows toward the stopper like the image on the left. The less liquid in the bottle, the more the bottle will need to be tipped.
  • Open the nozzle very quickly and the liquid will flow out of the stopper without dripping. If the liquid drips, you are not opening the stopper all of the way and/or quickly enough.
  • Spray in the direction of the arrows starting with the shoulder, followed by the neck, then the jaw and, ending in the temples.
  • The pattern for the shoulder (1), neck (2), two jaw muscles(3 and 4), and temples (5) are the same for each of the four sprays per side but since the temporalis muscle is shaped like a fan, you want to spray the entire muscle so follow the ‚Äčnumbers in the image to the right.
  • Each spray should take about 4 seconds, which is longer than you think.
  • For people who are not experienced using the spray, I suggest placing a cotton roll in the ear, and closing your eyes so that the medication does not get into the ear or the eye.
  • After spraying, stretch the jaw for 30 seconds preferably with the cork that Dr. Hirschinger provided to you.
  • The spray can be applied every 3 to 4 hours.

Caution: ethyl chloride is flammable so do not use it near an open flame, or smoke when using the medication.