Suggest remedy for pain and tenderness in neck

Posted on Mon, 28 Dec 2015 in Brain and Spine
Question: I have a bad pain in the back of my neck right under the skull. It hurts to touch it and the pain shoots up my head to my temple. Also, the same side of my face keeps twitching along with my eyelid. That eyelid feels heavy even when there is no twitching. Is this something I should seek medical attention for right away? Or does it sound muscular?
Answered by Dr. Ilir Sharka 49 minutes later
Brief Answer:
I recommend as follows:

Detailed Answer:

Thank you for asking on HCM!

Your symptoms seem to be related to occipital neuralgia, which is a headache originating in the back of your head, right under the skull.

Is your pain triggered by neck movements?

The twitching along your eyelid is not very common in this kind of headache, but it is known to cause irradiating pain in the temples and in the eye region.

The tenderness in that region and hurting while touching is another argument in favor of this disorder.

You should know that there are different causes of this type of headache:

-a cervical column disorder affecting the interventebral discs (a slipped disc could be the cause) or just degenerative cervical spine changes
-a neck tumor
-trauma in this region, etc.

Many times the cause of this disorder is not found, although all the performed tests.

Have you had any trauma in this region lately (on the back of your head)?

I recommend consulting with a neurologist for a careful physical examination and a cervical spine X ray study.

If suspicions for a structural cause are raised during physical examination further tests may be needed :
-brain and cervical spine CT scan or MRI
-blood lab tests (complete blood count, PCR, sedimentation rate)

There are different treatment options for this disorder (medications, surgery, locak nerve block, etc).

Antiepileptic drugs like Gabapentine, Carbamazepine, etc. have shown to be very effective in this clinical situation.

I recommend you discussing with your doctor on the above issues.

Meanwhile I recommend taking Indomethacine twice daily for a short period, until your appointment, if you have no contraindications to this drug.

Hope to have been helpful !

Feel free to ask any other questions whenever you need!

Kind regards!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 6 minutes later
Yes, there is pain when I turn my head or touch the spot. Sometimes the pain just shoots through the right side of my head. It also causes some tingling in my head when I press on the spot. I have not had any kind of trauma.
Answered by Dr. Ilir Sharka 2 minutes later
Brief Answer:
Your symptoms are compatible with occipital neuralgia.

Detailed Answer:
Hello again!

Thank you for the additional information provided.

Your symptoms are compatible with occipital neuralgia.

As I already mentioned before, although there are some known causes, sometimes no cause is found even after performing all the tests.

I recommend consulting with the neurologist and discuss the above mentioned issues.

Hope you will find this answer helpful!

I am always at your disposal for any other uncertainties!


Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 2 minutes later
Is there anyway it could be caused a brain anuerism?
Answered by Dr. Ilir Sharka 7 minutes later
Brief Answer:
There is no chance of an intracranial aneurysm.

Detailed Answer:
Hello again!

There is nothing to worry about that.

You should know that this nerve and its branches (three branches)originates in the cervical column, in the upper segment of the spine, just below the skull. The nerve and its branches travel under the skin, between the muscles and the scalp.

Brain aneurysms are inside the brain. So there is no chance of any connection between occipital neuralgia and intracranial aneurysms.

You should know that aneurysms cause a totally different kind of headache.

So relax! There is nothing to worry about.

If you have any other uncertainties, I will be happy to answer!

Best wishes!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 3 hours later
Hi I went on to the doctor and I have been diagnosed with trigeminal nueralgia. I was given a morphine shot for pain and a steroid shot. Can the steroid shot cause weight gain?
Answered by Dr. Ilir Sharka 9 hours later
Brief Answer:
A single shot of steroids does not lead to weight gain.

Detailed Answer:
Hello again!

Trigeminal neuralgia can explain the face and eyelid twitching, but can not explain the region of the pain origin (back of the head, just under the skull).

Anyway, shots of steroids and anesthetics like morphine in the territory of trigeminal nerve are usually performed after trying antiepileptic drugs first for some time, and when they have not reached full control on the pain.

Anyway, there is nothing to worry for just a local injection of steroids. It will not induce any weight gain.

Steroids used for a prolonged time can lead to fluid retention and weight gain, but it is not your case.

I recommend performing a brain and cervical spine MRI study, because even in the case of trigeminal neuralgia, this is not a typical trigeminal neuralgia and other causes should be investigated (ruled out).

Meanwhile, I recommend starting an antiepileptic drug, if you have not started one. Gabapentine, which is effective in both trigeminal and occipital neuralgia and does not induce weight gain.

Hope to have been of help!

Wishing all the best!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Ilir Sharka


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