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Suggest Treatment For Degenerative Disc Disease And Severe Frontal Headaches
Question: Hello, my name is XXXXXXX and I am asking this for my husband. He has degenerative disc disease and had had fusion at C6 to C7 4 years ago. In the last year he has developed long skull indentation on the right side of his scalp. He as suffered f rom many headaches and has had many radio Frequency Ablations on C2, c3,c4 and the Ociput on his right side. 2 months ago he had c2,c3, c4 fused and a gangiliontecomy of the C2 nerve root. He has been suffering form frontal headaches severe since last October. We were hoping theses pas procedures would relieve the headache pain. But no improvement as of yet. Do the indentations have anything to do with the chronic front lobe headaches? He is at the end of his rope the pain is unbearable. he currently takes 20 mg of Opana ER daily and 2-4 mg of levorphanal tartate for break through pain due to the degenerative disc. The headaches are horrible and they are constant.
Brief Answer:
Further evaluation and tests needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns about your husband's condition.
At this point, it is a little difficult to name the exact cause of the headaches.
First there's need for some clarifications about headache type such:
- is the headache constant or intermittent during the day?
- does the headache interfere with sleep, or awakes your husband?
- what about any relationship of headaches with weather changes?
- how much is the headache relieved by drugs use?
- any fever, congested nose?
- any other symptoms such nausea, blurred vision, worsening of headaches by light, noise?
- what about blood pressure levels?
- any blood tests done and results?
Second, there is need for a neurological evaluation by a neurologist about distribution pattern ( if pain follows a nerve distribution pattern, then headache is most likely to be related to occipital neuralgia that is treated partially).
Third, and most important in my opinion, there is need for head and brain imaging studies ( CT, MRI) in order to exclude/ evaluate any organic cause of headaches, sinusitis, the nature of indentations.
If the indentations are located at procedures sites, most probably are side effects of procedures.
In my opinion, occipital neuralgia treated partially is the most possible cause of the headaches, but other possible conditions should be evaluated/excluded.
Besides opioids, a good symptoms control may be achieved by Amytriptiline or Gabapentin use.
Since these are prescription drugs, there is need to discuss with your husband's treating Doctor about their use and about imaging studies getting done.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Further evaluation and tests needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns about your husband's condition.
At this point, it is a little difficult to name the exact cause of the headaches.
First there's need for some clarifications about headache type such:
- is the headache constant or intermittent during the day?
- does the headache interfere with sleep, or awakes your husband?
- what about any relationship of headaches with weather changes?
- how much is the headache relieved by drugs use?
- any fever, congested nose?
- any other symptoms such nausea, blurred vision, worsening of headaches by light, noise?
- what about blood pressure levels?
- any blood tests done and results?
Second, there is need for a neurological evaluation by a neurologist about distribution pattern ( if pain follows a nerve distribution pattern, then headache is most likely to be related to occipital neuralgia that is treated partially).
Third, and most important in my opinion, there is need for head and brain imaging studies ( CT, MRI) in order to exclude/ evaluate any organic cause of headaches, sinusitis, the nature of indentations.
If the indentations are located at procedures sites, most probably are side effects of procedures.
In my opinion, occipital neuralgia treated partially is the most possible cause of the headaches, but other possible conditions should be evaluated/excluded.
Besides opioids, a good symptoms control may be achieved by Amytriptiline or Gabapentin use.
Since these are prescription drugs, there is need to discuss with your husband's treating Doctor about their use and about imaging studies getting done.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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