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Took flexeril for throbbing pain in neck. Have not got the cure. Should i be concerned?

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Practicing since : 2004
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I am a nurse with a throbbing h/a x 1 wk. It is alleviated with motrin but returns as soon as it wears off. It is frontal and temporal with severe neck pain (+ hx arthritis). I blamed it on tension but cannot get it to abate. Took flexeril last two nights without improvement. Had visible pulsating vein to left temple last night. Tired of hurting. Should I be concerned? No neuro deficits. + intermittent dysequilibrium. L > R. No hx migraines. Miserable! I realize this may be silly...but just never lasted this long.
Posted Mon, 31 Dec 2012 in General Health
Answered by Dr. Ashish Mittal 3 hours later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     37 year old female health care professional
•     Total duration of suffering: 1 week
•     Known case of Pernicious anemia, inflammatory bowel associated arthritis, heart XXXXXXX diastolic dysfunction, crohns disease (in remission)
•     Complaints of: excessive stress, frontal and temporal throbbing headache with severe neck pain, L>R with visible pulsating vein to left temple.
•     Response to motrin (ibuprofen) +

From the history, I would like to consider multiple possibilities for cause of headache in following hierarchy:
•     Stress or anxiety related: if present with pain or exacerbation of pain due to stress or anxiety. As you are already reporting stress. Avoid stressful situation and take leave to relax. Relaxation exercise like JPMR and breathing exercise will help. In excessive stress short course of benzodizepine under psychiatrist supervision will help.
•     Migraine or Aneurysm: less chances. In these condition patient experience severe and bursting headache. Although chances are least but their possibility can not be rule out only from clinical presentation. Migraine is more common in middle aged female, so its onset should not rule out. Till evaluation complete, you can take motrin for symptomatic relief.
•     Hope there is no problem related to high BP, ear-nose-throat problem, dental problem. If suspected but not evaluated, then get evaluation done.

It is better to fix appointment with neurologist to rule out CNS pathology first, as you may also need MRI. In such distress take support of others and do not self medicate. Apart from that follow advice as mentioned above.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Dr Ashish XXXXXXX Mittal
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