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Neurology (Expert Forum)
Migrane headache with neck pain
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Migrane headache with neck pain
by Weldon, Dec 26, 2000 12:00AM
I am a 43 yr old male that has suffered with migrane headaches all my life. The migrane occurs primarily on the right side (99%). Lately (1yr) I have been experiencing a "knot" in my neck that accompanies the migranes. I begin to feel a stiffness in my nect which grows, and then a headache begins to follow. This doesn't happen all the time, but about 50% of the time. The neck pain is also on the right side just at the base of the hairline. Typically the migranes have gone away after overnight sleep and no medication has ever helped. I went to the neurologist and he prescribed Maxalt. I took this drug on one occasion and it seemed to relieve the headache athough I remained "dull" feeling. Prior to that I had only used Ibuprofen, with minor results. He did MRI's of the brain and neck and said everything was normal except I had two bulging discs at C4-5 and C5-6. He said that they were not touching the cord so it was nothing to worry about. I've always had a "stiff" neck with somewhat limited motion and a "grinding" sound when I rotate my neck. I saw a chiropractor once and when he "adjusted" my neck, it instantly felt like it was on ball bearings. One other thing that I noticed was when I laid flat on the bed (during headache/neckache)and had my hands raised (flat) above my head, both fingers/hands went to sleep (numb/tingle). My migrane frequency has greatly increased over the past 3 months (one/week vs. one/2 months), as has my stress level, and none of the usual "helps" work now. My question is: Does it sound like the cervical discs could be aggravating the problem, or causing a new problem altogether? Anything else here ring a bell? Thank you for any responses.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Dec 26, 2000 12:00AM
Dear Weldon:
Sorry to hear about your migraines. Whether your disc problem is contributing to your migraines symptoms is unknown and difficult to tell over the internet. Usually, we think that a disc buldge that does not compromise the cord contributes little to symptoms. But, there are patients that have no cord compromise and have complaints, and after rehab their complaints disappeared. So, I am not sure what to tell you. Most likely, it is not contributing to your problems. I say this because the muscles in the back of the neck are mostly contribute to the arms areas and not the neck. I can't tell you whether the numbness you feel when you raise your arms over your head during a migraine is due to the disc buldge, but I think not. If it were, it would also happen without a headache. Migraine frequency can change at times. Sometimes the more medications used, the more frequent they become. Other times, the increase in stress or fatigue can trigger more migraines. The abortive medications such as Maxmalt or Maxalt stop the migraine once it has started. We see about 60-70% of patients have their migraines stopped with this medication. The earlier in the course of the migraine it is taken the better it works. I hope I have answered your question.
Sincerely,
CCF Neuro MD
Sorry to hear about your migraines. Whether your disc problem is contributing to your migraines symptoms is unknown and difficult to tell over the internet. Usually, we think that a disc buldge that does not compromise the cord contributes little to symptoms. But, there are patients that have no cord compromise and have complaints, and after rehab their complaints disappeared. So, I am not sure what to tell you. Most likely, it is not contributing to your problems. I say this because the muscles in the back of the neck are mostly contribute to the arms areas and not the neck. I can't tell you whether the numbness you feel when you raise your arms over your head during a migraine is due to the disc buldge, but I think not. If it were, it would also happen without a headache. Migraine frequency can change at times. Sometimes the more medications used, the more frequent they become. Other times, the increase in stress or fatigue can trigger more migraines. The abortive medications such as Maxmalt or Maxalt stop the migraine once it has started. We see about 60-70% of patients have their migraines stopped with this medication. The earlier in the course of the migraine it is taken the better it works. I hope I have answered your question.
Sincerely,
CCF Neuro MD
Your symptoms are what I go through. The only excepion is that I can not lay down when I am in a spell.Laying down makes me worse. I have to sit straight up in a chair or on the sofa with my chin resting on my chest and sleep.I also have grinding in the neck and can not rotate to the right smoothly past 45 degrees.Phy. Ther. made me worse.The next day after a session I would wake up with a headache.I have been prescribed, Vioxx,Celebrex, Imitrax and some stuff like Meth---- that I had to take six the first day,five the next etc down to one on the final day. So far nothing relieves. The big problem for me is being seen when I am having a series. It seems that I can get an appointment when I am fine, but not when I am having the headache
MRI, Cat scan and X-Rays show nothing. A clean bill of health. Strees has been a factor, but I keep in mind that I control the stress in my life and it will only get to me if I let it. Primarily I do not dwell on things I can not change or make me angry.
In that I am chiropractor, what do you mean that "felt like it was on ball bearings"? If you went for just one treatment and expected miracles, you have done yourself a great diservice. The knot in your neck then a headache is a indication that the neck may indeed be the locus of your problem. Return to the chiro and continue the course of care the you were probably given.You may receive the results you have been looking for with the use of drugs.
Because there are so many variables in food allergies, they are often ignored as the cause of migraines. One needs to observe even 24hrs. after ingesting a suspectd food. The main foods that have been known to trigger migraines are: Chocolate,
cheese, wine, and seafood. There are more, and also, some react as I do to MSG, which is often in chicken soups, chinese food,and pizza. It is used to enhance flavor. I personally have found not all chocolate is a problem. I hope this may help.
Lie down on the floor on your back. Get someone to put their hands on the floor with their fingers pointed straight up at the ceiling. Let the weight of your head rest on their fingers by placing your neck on their fingers. You haed will slowly "fall". It will come to rest in the person's hands. Also pinching the neck and applying firm pressure helps to relaese the tense muscles. I am not a massage therapist but I do get massages sometimes. I think a deep tissue massage could do no harm. See if there is a migraine or headache specialist in your area. I did and it helped a lot. Good luck
I just had my first real migraine in 15 years . . . my neck was killing me, yet my pain was in the top of head and sorta throbbed and my eyes hurt. Nothing would make the pain stop. Not caffeine (I get withdrawal headache