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Neurology  (Expert Forum)
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Chronic daily headache, Alot of neck/shoulder pain!
Answered by
Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

Chronic daily headache, Alot of neck/shoulder pain!

by 24/7 Pain, Jul 16, 2007 12:00AM
I have had chronic headaches for 2 years. The headaches themselves remained daily (usual on sides of head, occasionally on back of head) with a decrease in the sever flare ups but still no clear pain free periods. Most days I have a constant mild to moderate ache in my head which varies in intensity throughout the day with flare ups of really bad pain once or twice a week. The Bad headaches tend to be on one side, sometimes spread to whole head and hurts more if I move my head. The pain is sharp and my head almost feels like it’s swollen. My daily headache feels like a tension headache although sometimes one sided and I often feel tension or weird sensations in the Left side of my head, neck and shoulder. I can have a good day with my headache but be in a lot of pain in my neck/shoulder. I now suffer from this on at least five out of seven days a week. I often feel tightness in the top of my back on awaking as well as in top of shoulder and side of neck and pain is commonly at angle of neck and shoulder and on my shoulder/blade. The diagnosis from my neurologist is transformed migraine although not 100% positive. Is it common for daily headache sufferers to have a LOT of neck/shoulder pain? It has been present since the second week of my two year headache and seems strange that headaches are getting easier but neck/left shoulder hurts like hell. Could it be cervigenic headache? Please help me!!
Doctor's Answer

by Cleveland Clinic, Aug 31, 2007 01:58PM
To: 24/7 pain
Wow your problem certainly has hit a nerve and generated a lot of discussion. As you can tell, you are not alone with your problem. Patients can certainly have a change in there headache going from migaine type symptoms that then become daily. Often this is the result of medication overuse causing rebound phenomena. I think it is important that you evaluate your rx medication use as well as over the counter medications. If you use a lot of caffiene or take medication with caffiene in it then rebound is very common and it will be unlikely that you will gain control without stopping those medications. Moslty imaging studies fail to show a cause as I think has been your case. The neck can certainly be a generator of pain and since you are on the computer a lot you may need to look at a better ergonomic design. Some patients will do well with trigger point injections (steroid and lidocaine are given) into the occipital nerve if the pain is locallized. Pulsed Radiofrequency Ablation of the occipital nerve can also help some patients. I am not sure there is any quick fix to this problem but I hope I have given you some food for thought, GS
Member Comments (26)

by mike1105, Jul 16, 2007 12:00AM
I'M no MD-- just an ex dentist who suffered with this **** for years before fixing it on my own. It sounds to me like your headaches and shoulder pain are coming from your neck--specifically the neck muscles and more specifically the scalenes, and SCM muscles, probably with some help from the upper traps. you get his prblem from forward head posture--quite common in today's day and age of computers. You should get a book by Clair Davies called  the Trigger Point Therapy Workbook. Read the head & neck and shoulder sections and then go to work. Warm shower to loosen up the muscles, then triggerpoint work, then stretching.You can find great scalene/trap/SCM stretches all over the net. You also need to have good posture thru the day--your head needs to stay balanced over your spine or else the muscles have to work too hard and go into spasm--see a website by Jolie Bookspan for this or get a little red book by Paul D'Arezzo on posture. IF I am right, you'll feel better in a month or two, amybe less. The more often you do the therapy, the quicker you'll get better. I did it 3x per day for 45 minutes each time. Pain free now

by 24/7 Pain, Jul 16, 2007 12:00AM
To: Mike
I have the book but have not done nearly as much work as you have. Do u do 45 mins every day. Also, was your headache constant and one sided and came out of the veiw. I am at present having some trigger point dry needling which seems to have helped the headache but the shoulder/neck (left side still hurt like mad, daily). Sometimes my arm aches too, pain is best described as tight and stinging. Could we keep in contact?

by mike1105, Jul 16, 2007 12:00AM
i am happy to keep in contact with you, as long as you realize I am not an MD and am not prescribing treatment,-- I am only offering you my experiences--you should consult with your MD before you treat yourself. my email address is ***@****. contact me there and i wil tell you my story and how i fixed it. In short, it was 45 minutes per session-- 3 sessions per day every day. Dont say you cant do that. 1 before work 2 lunchtime 3 after work 4 bedtime--there's 4 !!!! Plus you can work certain areas with a theracane for 10 minutes a dozen tomes per day if you want. I work my scalenes and SCMs at least 6 times per day-- I do it while I am watching television. Please answer these questions.
1. are you on the computer alot?
2. do you have tightness in your chest muscles in addition to the shoulder and arm symptoms
3. do you have what seems to feel like circulatory issues in your arm(s)?
4. what do you do for a living?
5. Are you overweight?
6. how old a are you?
7. M or F
8. (only if you want) If F, are you large chested? (trust me I have a reason for that question)

by MoonBunny316, Jul 17, 2007 12:00AM
I can totally understand your pain...I was diagnosed with chronic and tension migraines about 4 years now and what helped me most was physical therapy...and some simple excercises that helped strecth the neck muscles.

by 24/7 Pain, Jul 17, 2007 12:00AM
To: Mike
Hi Mike

Thanks for taking the time to help me and I do understand that you are not a MD. For a more detailed version of my story visit my blog at www.dailyheadache.co.uk . In answer to your questions

1)I am on the computer a lot. The day I got my headache I had spent the morning looking up (for about 4 hrs with breaks) as was controlling a winch to the top of an electricity pylon

2)I have a small amount of peck pain on my left peck. This is on occasion as compared to my left sided neck and shoulder pain which is more or less constant. I also get pain just around my shoulder blade.

3)My arm feels heavy and weak, not sure what causes it but does it sound like a CIRCUITORY ISSUE? (again this is not all the time, bout 20% of the time)

4)I was working on the electric pylons, replacing parts, but since my headache and pain start, came on one day out the blue, I have not worked as until the last month or two I have had a headache that on its best day is moderate.

5)I am a 23 year old male

6)I am not overweight, I weigh 10 and half stone.

7)Also sometimes my neck feels weak, I can feel tension sensation in neck and head