Question: hello, I am the wife of a 64 year old man in chronic pain treatment for 3 years now. He has some back pain but his main problem is severe pain at the base of his skull on the left side and sometimes the right side. he has undergone a procedure to open up the cervical spine to relieve pressure on the spinal cord but that seemed to not help and he is supposed to undergo a radio frequency ablation. I am worried if he has chiarri or something. He is on 4 oxycodone a day and gabapentin 600 x4 day and Cymbalta and it seems this level of pain could have other cause. XXXX

You are not going to use an oncologist to answer, are you?

Have many MRI's and I think the final diagnosis is occipital neuralgia but I would think that would not be that hard to control the pain from. He is on gabapentin and muscle relaxants but also on oxycodone. I am really wanting to get him off oxycodone. The latest recommendation is radio frequency at the site. I can rub his neck and feel tightness where the tendon attaching into the skull is at the back of his head. He has bad posture and has worked on a computer for many, many years. I will have them try the radio frequency but have to wait until he is off blood thinner following an unnecessary stent late last month. We are going on a trip so I am thinking about discussing repeat trigger point injections (they say a series of 3 in a row) and maybe a brace of some type for his (what looks like) kyphosis. We are well into this as he has had this for years and years but after surgery; the pain got so severe he had to go on narcotics for chronic pain. He also has severe muscle wasting and am thinking of starting him on testosterone as he is very low and one doctor told me that no matter how much protein I have him eat; he will not build muscle without testosterone. I am using you as a sounding board. What do you think?