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Suggest treatment for severe headache and neck pain

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Posted on Mon, 21 Sep 2015
Question: In May I started to get a sore spot on my right side of head and neck pain It was an annoying pain. I couldn't wear a head band because it was annoying. Went to doctor she treated me for sinuses. Also gave me a shot. Went back to another doctor when pain cam back on right back side of ear kind of below and steaight forward. He gave me nasal spray and it didn't work. I was scared I had a brain tumor so I got a ct scan and came back negative and said sinuses looked good. He gave me allegra for drainage. Mid July comes around and my pain leaves for about 10 or more days. I noticed the pain slowly coming back when it was a hot day and I hadn't drunk much water. Slowly creeper back. I was getting shooting pains in neck and head up right side. Sometimes burning. One time where the head and neck meet those places radiated with pain almost most lime a migraine. I puked and called doctoe. He gave me Amoxil bc I went to the doctor before and I had a slight temp. After about a week doctor told me I had migraines. I didn't believe him. Because I have pressure and dull pain on right side. Tried imitrex and it was okay but I didn't have bad headaches. Went back again and he put me on nortriptyline. After that I had pressure I. Temples and ears feel full. Went to neurologist and said I have occipital triangle myaliga. Told me to stop taking nortriptyline and just take cyclobenzaprine. Did that for about a week and went to pain doctor. Neurologist sent me there for nerve blockage. She put me on cymbalta and I hate it. Upset stomach part is no fun. Take zofran for that. I don't know what to believe. I have no appetite and have tons of anxiety. Three months of pain is eniufj. Yesterday I had bad headache. It was radiation g out of the same spots where I got that Terrible headache before. My head is really sore today. Lots of sensitive spots in my head. Stomach hurts probably due to not eating. What do you think I have?
Also had blood work done and it came back good. Every time I get done I feel so much better but then in a couple days the pain appears more noticed. Why is that? Am i losing my mind? Is this all anxiety?
This week symptoms are more neck and lower head tightness right up the middle. As I'm typing my stomach was churning and I got hot and the place where your neck and head meet began to hurt alight. It's like I felt it go up that nerve. Help!
doctor
Answered by Dr. Dariush Saghafi (1 hour later)
Brief Answer:
In part may be due to anxiety but also medication effects

Detailed Answer:
Good morning. My name's Dr. Saghafi and I'm an adult neurologist as well as headache specialist who says many cases such as yours at the VA Medical Center and so I'd like to recommend both similar treatments as well as advice that I pass on to all of patients and especially those with symptoms such as yours. The type of headache you have can be a couple different types...and perhaps, you even have at least 2 different types anyways. But whatever the case what you should not do anymore for any reason is have a chiropractor manipulate your neck. This is a dangerous procedure and one which can leave you quite disabled or worse. I've witnessed 3 women during my training who had all visited the chiropractor within 2 hrs. of being brought to the ER for major complications of stroke after having their necks "adjusted" and 2 of them had serious strokes which resulted in permanent disabilities and one died after several days. She was in a coma from a blood clot that wiped out her brainstem and we had to pull life support off....entirely unnecessary consequences in my opinion. I regularly tell people of the dangers of this procedure and urge them to do their reading on the subject on the Internet before making a decision. Hopefully, people are making better decisions now compared to a few years ago since the rate at which people were flocking to chiropractors for something was so high that it was getting ridiculous.

After reading your first paragraph with all the changes and rapid cycling you have of medications for these headaches/head pains I also believe you may be suffering the effects of polypharmacy which means, "too many damned drugs." There is something called MEDICATION OVERUSE SYNDROME....and while your situation is not exactly the same as classic MOH; it certainly could be a reasonable variant. In other words, a lot of medications which are prescription as well as over the counter substances are being thrown at you without:

1. Having a clear cut and unified diagnosis (though the neurologist seems to think you've got OCCIPITAL NEURALGIA)
2. Giving your body a chance to really wash out of 1 set of drugs before starting another.

Therefore, I think your body may be suffering from a possible baseline headache condition with MULTIPLE CAUSES (etiologies)which could be mild migraine types (don't have to be SEVERE, SEVERE but they can have many of the symptoms you've described) along with Tension Type, medication induced polypharmacy sequelae, possibly Occipital Neuralgia although your current symptoms are a bit sketchy for that diagnosis, and last but not least headaches tied together with your issues of depression, anxiety, and perhaps some of your own medical problems.

You mentioned about your headaches getting worse when the temperature gets hot. Did you know that for every 7 degrees F that the outside (or inside) temperature rises above 72 degrees F that approximately 20-30% more individuals with predisposition to headaches will have worsened headaches. In your little blurb you mentioned how your headaches seemed to come back around the time things got really hot.

I hope these answers address the question sufficiently and if so would appreciate your considering rating this interaction as a high star event with some brief written feedback. Also, in view of end of the month tallies and credits I'd very much appreciate if you'd CLOSE THE QUERY at this time (assuming I've provided with you enough information to get things well under way). We can always have more discussions under a separate thread at a later date if you so desire.

BTW, you're NOT losing your mind but your anxiety levels certainly can be contributing to the baseline headaches. It would be to your benefit (though you may be having a little bit of trouble believing it) to stop all the medications being given to you for any acute pain or headache relief as well as start keeping track of the headaches with detailed descriptions of what their symptoms, duration, and other odd feelings may be that should be documented.

With several weeks of good coherent data keeping with the logs we can have these diagnosed in no time (if you go to a headache specialist) and then, be on better footing as well as what type of treatments would be best in your case.

Please send me your future questions to: bit.ly/drdariushsaghafi

It would be honor to answer your questions quickly and comprehensively.

This query has required a total of 20 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dariush Saghafi

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Practicing since :1988

Answered : 2473 Questions

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Suggest treatment for severe headache and neck pain

Brief Answer: In part may be due to anxiety but also medication effects Detailed Answer: Good morning. My name's Dr. Saghafi and I'm an adult neurologist as well as headache specialist who says many cases such as yours at the VA Medical Center and so I'd like to recommend both similar treatments as well as advice that I pass on to all of patients and especially those with symptoms such as yours. The type of headache you have can be a couple different types...and perhaps, you even have at least 2 different types anyways. But whatever the case what you should not do anymore for any reason is have a chiropractor manipulate your neck. This is a dangerous procedure and one which can leave you quite disabled or worse. I've witnessed 3 women during my training who had all visited the chiropractor within 2 hrs. of being brought to the ER for major complications of stroke after having their necks "adjusted" and 2 of them had serious strokes which resulted in permanent disabilities and one died after several days. She was in a coma from a blood clot that wiped out her brainstem and we had to pull life support off....entirely unnecessary consequences in my opinion. I regularly tell people of the dangers of this procedure and urge them to do their reading on the subject on the Internet before making a decision. Hopefully, people are making better decisions now compared to a few years ago since the rate at which people were flocking to chiropractors for something was so high that it was getting ridiculous. After reading your first paragraph with all the changes and rapid cycling you have of medications for these headaches/head pains I also believe you may be suffering the effects of polypharmacy which means, "too many damned drugs." There is something called MEDICATION OVERUSE SYNDROME....and while your situation is not exactly the same as classic MOH; it certainly could be a reasonable variant. In other words, a lot of medications which are prescription as well as over the counter substances are being thrown at you without: 1. Having a clear cut and unified diagnosis (though the neurologist seems to think you've got OCCIPITAL NEURALGIA) 2. Giving your body a chance to really wash out of 1 set of drugs before starting another. Therefore, I think your body may be suffering from a possible baseline headache condition with MULTIPLE CAUSES (etiologies)which could be mild migraine types (don't have to be SEVERE, SEVERE but they can have many of the symptoms you've described) along with Tension Type, medication induced polypharmacy sequelae, possibly Occipital Neuralgia although your current symptoms are a bit sketchy for that diagnosis, and last but not least headaches tied together with your issues of depression, anxiety, and perhaps some of your own medical problems. You mentioned about your headaches getting worse when the temperature gets hot. Did you know that for every 7 degrees F that the outside (or inside) temperature rises above 72 degrees F that approximately 20-30% more individuals with predisposition to headaches will have worsened headaches. In your little blurb you mentioned how your headaches seemed to come back around the time things got really hot. I hope these answers address the question sufficiently and if so would appreciate your considering rating this interaction as a high star event with some brief written feedback. Also, in view of end of the month tallies and credits I'd very much appreciate if you'd CLOSE THE QUERY at this time (assuming I've provided with you enough information to get things well under way). We can always have more discussions under a separate thread at a later date if you so desire. BTW, you're NOT losing your mind but your anxiety levels certainly can be contributing to the baseline headaches. It would be to your benefit (though you may be having a little bit of trouble believing it) to stop all the medications being given to you for any acute pain or headache relief as well as start keeping track of the headaches with detailed descriptions of what their symptoms, duration, and other odd feelings may be that should be documented. With several weeks of good coherent data keeping with the logs we can have these diagnosed in no time (if you go to a headache specialist) and then, be on better footing as well as what type of treatments would be best in your case. Please send me your future questions to: bit.ly/drdariushsaghafi It would be honor to answer your questions quickly and comprehensively. This query has required a total of 20 minutes of physician specific time to read, research, and compile a return envoy to the patient.