Migraine or Cervical-How to Distinguish Which It Is

[arlenebt]

I've had chronic daily headache every day for the last 20 months; have been to 3 board certified neurologists, specializing in headache, had 3 MRI's, cat scans, blood work, all normal.  I know I have osteoarthritis in my cervical disc area, C4, C5, C6, and the physiatrist wants to do a facet joint epidural injection.  The problem is that my pain in not in the back of my head or neck, nor do I have tingling or numbness.  The EMG test on my muscles in my arms was completely normal, so I'm not sure I want this injection.  However, the neurologist I go to has me on xanax when I need it; on days when the headache pain is mild, I just tough it out; reserving the xanax for when I need to be out with people for hours, or when the pain is worse.  I could go for botox injections, which the neurologist mentioned, but it would be a lot better if I could rule out the cervical disc area.  Is there any way to distinguish where the pain originates?  There is no crunching in my neck or pain in my shoulders; there is no movement that makes the headache better or worse.  Also, meditation or any form of relaxation exercise doesn't do anything for the pain either.   Food triggers don't seem to make a difference in the headache either.  I have also tried accupuncture, without any improvement.   I can't figure out where to pursue this, with the neurologist (migraine or tension headache), or with the psysiatrist (cervical disc pain).  Has anybody had experience in these areas?

[arlenebt]

Thanks for your reply; my headaches are also constant, bilateral, move around--top of head, sides of head (like 2 rods were stuck in each side of my head), forehead, and rarely, back of head; intensity of pain can be mild (most of the time) to much worse (need to get home and rest in a chair).  The first neurologist gave me xanax, and it works better than anything else, but it's not the right medication, it takes the edge off the discomfort.  When the pain is mild, that's fine; when it's worse pain, xanax is not the solution.

When I get up in the morning, I have no headache; it starts about a half hour after I'm up, whether or not I have eaten anything or not.  I only have 1 c decaf coffee, and decaff tea the rest of the day.  I can walk or exercise, doesn't make the pain better or worse.

My next step (from the physiatrist) is for an osteopath on his staff to do osteopathic manipulation, because the physiatrist thinks my shoulder muscles and facet joints are "tight."  A young osteopath also felt my neck and shoulders and agreed with him.
I've tried accupuncture for the past 2 months; except for the lack of improvement in headache, I otherwise feel good and like the accupuncture, but I can't see myself continuing.  The accupuncturist claims I'm getting better (maybe so I come back every week).

I can't understand if I have cervical problems or migraine why the xanax works better than anything else I've tried--ibuprofen, aleve, tylenol, all inferior in pain relief, plus the doctor says NSAIDs should only be used 3 times a week.  Xanax can be used, at low doses, daily, but it can be addictive, so I'm not even happy with xanax.

Please add comments, and I'll stay in touch.  The osteopath visit is March 1.  Thanks.

[StormyRenee]

Hi,
I am 36 yrs. I suffer from Hemiplegic migraines and other migraine equivalents aswell. I also have degenerative disease at c5-c7 and dextroscloisis of the cervical spine. My brain mri shows about 15 spots/lesions that are typical for migraines. I have had neck/shoulder issues for about 5 years and am prone to cervical strains. But the headache/migrainal issues started a little over a year ago. I get Acephalgic migraines alot. But when I get one that actually causes pain it always involes the entire side of my face and eye. My arura's mimic stroke with facial drooping,paresthesia and  weakness(hemiplegic migraines).
Have any of you had a Lumbar Puncture? When migraines are severe you should get one to rule out other causes.....

[painterchic]

Hi, just read your post, I am on the quest to find what is wrong with me and/or stop these horrible headaches.I have been seeing a neurologist, and I just had an MRI on my cervical spine this week to rule out any problems there (tumor removed/spinal fusion when I was younger) now suffering from facial pain and headaches. This is after traditional migraine meds failed. I am currently on tergitol which is not doing much. I am fine when sleeping but as soon as I open my eyes there it is. It is worsened by activity, etc. It is sometimes worse than others and originally was only on one side, now both, all over.
I am curious to see what you find out with your results, as it is rare to see someone with similar symptoms and the C6 spine connection like I am investigating, more to rule out, but you never know. At this point who knows. Thanks.

[bbgirl011]

Topamax is suppose to be a good prevention of headaches. I'm on it but it doesn't do anything for me for my headache prevention at 200mg. Ask your doctor about it and see what they say. For some people it does do wonders in that department.

Topamax can be used for the helpful prevention of seizures, headaches, and as a mood stablizer.

I have a chiroprator, from my physiatrist, who recommended that I may have a vascular problem. I have my constant never ending headaches in my temples but then they move to the back of my head suddenly at random times. They also increase in pain randomly.

If I had to recommended anything, go to your physiatrist because they can help you eliminate possible things by referring you to different specilaists. It will be a long wait because there are alot of different specialists out there but just remember there is only one answer.

Good luck to everyone.

[arlenebt]

I'm trying to figure out if joint injection is something to try; if it's migraine, I don't want to go to joint injections; I would go back to the neurologist and ask for preventive medication; (I couldn't tolerate even 1 25mg Topamax; it left me spaced out).  Botox is also an alternative.  By the way, the pain is bilateral, it varies in locations in my head, but not usually in the back; typically the pain is on top, forehead, or on both sides.   Is there any way to figure out who to go to--the neurologist or the physiatrist?  Thanks.

[Dr Santos]

Hi,
How are you? It is good that the tests were fine. And I'm sorry to hear that medication and complementary medicine are not helping. Some types of pain may be referred to other locations especially if nerves are affected. If tests are normal, you can try the more conservative approach first before doing more invasive  joint injection. Take care and do keep us posted.