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Neurology  (Expert Forum)
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Constant Headache
Answered by
Cleveland Clinic
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.

Constant Headache

by Blonde456, Sep 06, 2009 09:00AM
I have had a constant headache for the past 2 ½ months.  I have the following symptoms.

*Constant pain on top of head (24/7)
-aching/burning feeling
-sometimes feels like a stabbing pain
-most of the time the pain felt is towards the front near my forehead
*Facial Pain (on and off)
-Mainly my right cheek (pain feels aching/burning with a feeling of numbness occasionally) and sometimes  
         my upper forehead
*Tooth pain (on and off)
-The front tooth and gum

I haven't had any other symptoms (dizziness, nausea, etc.). My question is has anyone experienced a constant headache with the symptoms I listed or know what could possibly be going on? I am worried that I constantly have a headache and just looking for any info anyone might have. I have seen my dentist and had a CT. The CT was normal and the dentist couldn’t find anything wrong with my tooth (he did an x-ray of the front tooth).  I have also seen a Neurologist. She prescribed me Nortriptyline, but it hasn't helped at all (been on it for 4 weeks).  I appreciate any info anyone has.

by Sara Khan, Sep 08, 2009 07:49PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

What you are describing is called " Chronic daily headaches" and is a common diagnosis. Usually patients give a history of frequent headaches, requiring a lot of over the counter medications, and finally the headache turns in to a daily headache unresponsive to medications. Do you have a history of migraine headaches ( one sided headaches, with nausea, vomiting, aversion to light and sound?) or a family history of migraine headaches? If you have had headaches with the characteristics I just described, then you may have had migraines which have now converted to chronic daily headaches.

Another interesting thing that you mentioned is tooth pain. A lot of people grind their teeth at night, unbeknown to them. At first it doesn't cause any problems, but over time it can result in tooth aches and then chronic headaches. There may be tenderness when you press down on your temples, face or jaw joints in the morning. Dentists who are "temporomandibular joint dysfunction" experts deal with this. Treatment is usually with a mouth guard, and this relieves the headaches.

Nortriptyline is a good drug for chronic headaches, and prevents further headaches but will not break your current headaches. If your headaches have not been relieved by medications such as Aleve and tylenol, you may require infusion therapy to break these headaches, before the Nortriptyline can take effect. These infusion therapies are usually regularly done in neurology departments which have headache centers. It would be worth bringing this up with your neurologist, or going to see some one who specializes in headaches.The dose of Nortriptyline can be titrated up as tolerated until the desired effect is achieved. If Nortriptyline does not work, there are a few other options available to use as a preventative medication, which you should discuss with your neurologist

I hope this helps. Good luck!
Member Comments (5)

by jenrish87, Sep 14, 2009 12:45AM
Wow, I actually thought I was alone.I was diagnosed with migraines at the age of 7 and the have slowly changed over the years. I have had the constant headache on the top of my head for 6 years now, and I also get the throbbing facial pain. I have been diagnosed with chronic daily headaches and have been through two different neurologists who have both put me on nortriptyline and topamax neither of which have helped. After the first time being put on nortriptyline I started to realize I saw fireflies or spots in my vision so I went and saw a optometrist who said I had no floaters, my bp was low, and everything was good. I then realized these fireflies changed when my migraines got worse, so its migraines with aura, to more of going through a tunnel. I also can see my heart beat in my vision. I have no idea if constantly seeing the fireflies is a result of all the meds or is the chronic headache, but what I do know is that it gets annoying. My doctor has recently put through 3 different IV treatments, valporate, kempra, and vimpat (all misspelled I am sure), to stop the headaches but nothing has helped. He is wanting to try botox, but insurance is not allowing it. Basically at this point I am getting frustrated and I am starting to believe nothing will help. I don't want to live in pain forever, I am still really young.

by turkee23, Sep 15, 2009 07:22AM
the other day at work i had one of these happen to me i got a terrible headache, throbbing behind my left eye badly, then i started seeing those "fireflies" and got dizzy and ended up throwing up.... i went home and laid down for a while and felt better after that, no meds helped me at all.today i still have this "funny" feeling in my head like still alittle dizzy but no pain as of now...... im wonder was that a migraine?... i never had one, but i do get alot of head aches..... kinda freaks me out cause i dont want it to be anything worse.....please any help would be much appriciated....thinking about making a doctor appointment

by jenrish87, Sep 16, 2009 08:38AM
To: to turkee23
Migraines present in a lot of different ways so it sounds quite possible to me that it could be one. If you aren't sure go see your family doc or better a neurologist who should help either get to the bottom of the problem or at least get you on some meds that could help. Also, I have found that doing research on your own about the different kinds migraine disorders empowers you because some doctors only seem to want to treat one or two things not the whole problem.

by melindafern, Sep 19, 2009 10:18PM
To: turkee23
Hello,yes i believe that was a migraine.i suffer from chronic headaches/migraines.
i always throw up witha migranie.always.
imitrex helps my migraines,however i suffer the side-effect,which is A TINGLING AND STIFF FEELING IN MY FACE.but its better than the migraine. ask ur dr about imitrex.
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