Hey Frank! 

Thank you so much for your response. I am advanced trained and have tried several of the needling techniques. He has had most relief with cervical side glides and was/is very limited in C3 with more boney palpation on Rt (only had xray from chiro and can feel with palpation). He is not painful with side glides and usually feels better after them, so I have not seen a reason to get another xray specifically of his spine, but still considering the mouth open xray (his current PCP wanted to see if he failed PT before doing imaging or referring so didn't want to order xray) I might need to call and talk to her directly, he just told me that today.

I have needled Greater Occipital, Cervical Spine, Greater Auricular, angular needling to temporalis muscle and anterior to the ear (as seen in picture attached). He had increased symptoms in his temporalis following the needling other than cervical spine (it was completed on a different day). His pain was increased for 5 days and constant after without significant relief. 

Other symptoms/objective measures found: cervical spine stiffness Rt to left>L to R with side glides, limited C3>all others, OA/AA mobility is limited (tested in full cervical flexion test) and muscle energy techniques do improve ROM and do not change his temporalis symptoms. Rt UT tightness and limited scapular stability on Rt with increased upward rotation, anterior scapular tilt and tight pec minor. Rt shoulder sits 1 inch higher than left noticeable with sitting posture. 

Thank you again for all your guidance, He's been to so many doctors and I can change his pain which is the first practitioner to do so, however I can't seem to make it go away and only decreasing the intensity for a few hours. 

Looking forward to hearing if I am still on the right track, and if you think I should be doing anything more than the above needling technique which I plan to try next session. I sent a picture to make sure I understood your directions correctly. Thank you again.