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Why am I experiencing pain in head, neck and upper back while standing or sitting?

Nov 2013
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Practicing since : 1994
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My wife is having extreme pain in her head (specifically temple region) and neck/upper back every time she stands up or sits up. This came on suddenly - 2 weeks ago. She has never experienced anything like this prior. The pain is significantly worse in the mornings. She also has light sensitivity and her ears feel like they are ringing. No recent trauma. We initially visited an urgent care facility and they said it must be muscle spasms. We also visited a chiropractor who said her spine was out of alignment and has been treating her for the past week. Pain got significantly worse. We went to the emergency room upon the advice of a radiologist friend and they did a CT scan and MRI of her head. The results indicated no structural damage - no tumors, no aneurysm or anything of that sort They suggested it is possible that she could have some spinal fluid leaking and might need a blood patch, but indicated a specialist would need to diagnose this. The pain meds they gave produced an allergic reaction in my wife. We have an appointment with a neurosurgeon in 6 days, but the pain is becoming progressively worse. My wife cannot stand or sit without extreme pain in her head. She describes it as a rush of pain that starts in her neck and goes to her temple. She can barely stand and last night started having sharp pains in her head while in bed. Is there anything else we can do or any other type of surgeon we can get into in a shorter amount of time? The ER referred us to a neurologist, but he said he only specializes in epilepsy and would not see us. I found a well-recommended neurosurgeon who agreed to see her, but my wife does not know if she can make it that long - 6 days away. Is there any other type of surgeon or doctor that you would recommend we see or anything we can try to do to alleviate the pain.
Posted Mon, 10 Dec 2012 in Brain and Spine
Answered by Dr. Sudhir Kumar 33 minutes later

Thank you for posting your query.

The overall description of the symptoms, and the radiologist interpretation points to a cerebro spinal fluid (CSF) rhinorrhea (leak).

In this condition, there is a break in the bone (of base of skull), from where the brain water (CSF) leaks out. As a result, there is low CSF pressure, resulting into low pressure headache.

In this disease, headache is the commonest symptom, which tends to increase when upright (sitting or standing) position. Headache reduces on lying down.

The other concern is the risk of meningitis (brain fever), as infection can enter the brain through nose and the break in the skull bone.

The definite treatment is repair of the skull defect, which can be done by a neurosurgeon.

In the meanwhile, for relief of pain, following measures are useful:

1. Lying down most of the time,
2. Ensuring intake of plenty of fluids,
3. Using analgesics that suit her

I hope this helps. Please get back, if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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