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Causes for severe daily headaches?

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Neurologist
Practicing since : 2001
Answered : 502 Questions
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need help with severe daily headaches. seen several doctors and taken many drugs with no help. doctors have gotten to the point where they just tell me they can't help me. at wits end and in severe pain.
Posted Tue, 1 May 2012 in Headache and Migraines
 
 
Answered by Dr. Shiva Kumar R 35 minutes later
Hello,

Thanks for the query.

From the information given to me it looks like you are suffering from chronic daily headaches.
Chronic daily headaches are classified by how long they last — more than four hours or less than four hours. The common longer lasting headaches are Chronic migraine, Chronic tension-type headache, New daily persistent headache and Hemicrania continua.

I need more information from you regarding the details of headache symptoms, treatment taken in the past and investigations done. We can take this discussion further once you let me know the details.

Awaiting your reply

Sincerely,

Dr Shiva Kumar R
Neurologist & Epileptologist
Above answer was peer-reviewed by
 
Follow-up: Causes for severe daily headaches? 20 minutes later
my symptoms include severe pain in back and sides of my head and neck,nausea,vomiting,trouble sleeping due to pain. waking up with severe pain.Ive tried triptans,prophalatics,anti convulsants,antidepressants,muscle relaxers,chinese medicine with acupuncture and massage, anything you can think of for headaches, I've tried. the only thing that works is a nubaine/promethazine injection and thats not an answer. i can't get that everyday and have to pay big money to get it because i have no insurance. I've been to neurologists,ents,chiropractors,headache specialists and others and no one has come up with a solution. I've had MRI's,CAT scans,blood work(not exactly sure what was tested) and nothing abnormal. hope this is enough info.
 
 
Answered by Dr. Shiva Kumar R 56 minutes later
Hello,
Thanks for writing back.
From the details, it looks like you have refractory migraine which is not responding to routine medications and prophylactic therapy. Chronic daily headache (CDH) is most often due to a combination of migraine and Tension type headache. Another cause of CDH is analgesic abuse. If you are not over using pain killers, one can exclude the possibility of analgesic abuse headache.

So I personally feel that we can try a combination of Botox (Botulinum toxin) injections and prophylactic medications for your refractory headache. Botox is FDA approved for treatment of CDH. In addition a short course of steroids would be of benefit to control your headache. If you have not tried medications like Valproate and Topiramate, they are also worth a try along with Botox.
However, since you don’t have insurance, you’ll need to pay for Botox but it would be worth a try.
Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
 
Follow-up: Causes for severe daily headaches? 5 hours later
I'm really concerned about botox injections. i have had shots it my back and that made the pack pain so much worse. i could barely walk after leaving and have had worse back pain since. I hardly notice that pain anymore due to my headaches though so thats not my concern. I can't handle anything worse than this,I'm barely able to tolerate the pain now. Theres got to be a better answer than that. Although i do want to make it known that you've been more helpful than any doctor so thanks for that. They just tell me theres nothing they can do. Ive also tried both of those drugs you mentioned taking with the injections. i can definitely rule out med overuse because i don't have anything to take for it and haven't for a long time. Im really worried ill never get my answer,any other suggestions would be great. Thank u!
 
 
Answered by Dr. Shiva Kumar R 1 hour later
Hello

Thanks for the follow up query

Regarding the treatment of your headache, I personally feel you are suffering from refractory headache not responding to most standard medications. After going through your medical report and before concluding you to be a case of refractory migraine, I personally feel consultation with Headache specialist is required first to confirm the diagnosis and exclude secondary causes of Headache.

Multidisciplinary approach from Neurologist, Psychiatrist and pain management specialist would be the most ideal approach in you. Chronic pain rehabilitation program would help you to improve your level of functioning and quality of life while reducing the "suffering" element of chronic pain.

I am sorry you are dealing with this frustrating problem. Let me know if you have any follow up queries.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
 
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