Daily Baseline Headache

I have a daily baseline headache that is a tightness in the forehead and the rest of my head feels like a helmet around it.  During the day the intensity level fluctuates and becomes more/less severe along with neck tension, facial tension and ears plugging more.   This has been going on for over seven years.

In the least six months I’ve tried PT, went to the pain management clinic where I got trigger point injections for my shoulders and headaches.  The injections helped my shoulders my shoulder pain but not me headaches.

I’ve seen a GP, neurologist, ENT, physical therapist, allergist and chiropractor etc. about my headaches.

I have taken OTC medication and have had many various prescription medications. I have had Botox injections, acupuncture, exercises, diet changes etc. and still the headaches have not gone away.

I've had neck x-rays, cat scan and MRI. Nothing has shown up on from these scans.

Here are some of the medications I've taken for the headaches:
Propranolol, Gabapentin, Celexa, Prosac, Nortriptyline, Elavil, Robaxin, Topomax (topamax), Valproic, Flexeril and Fluticasone.  

I still feel there is something physically happening in my body that causes the headaches. Whether it's arthritis, constricted blood vessels, something in my brain or 100 other possibilities there's got to be a simple or complicated answer. Also I think with the right answer the headaches can be resolved.

Thank you,

Don

[Christopher R Newey, DO]

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 a doctor.

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

One of the most common causes of headaches in people with chronic headaches is called medication rebound or medication overuse headache: medications as simple as tylenol or advil if used too much can cause rebound headaches that are even worse then the headaches for which the medications were started for. This is very common and is most likely to occur with use of any medication for your headache more than a few times a week. It can occur with all the commonly used headache medications such as ibuprofen, triptans (such as imitrex), fioricet, and commonly with any type of narcotic such as tylenol #3, dilaudid, percocet, etc. The treatment is difficult, but basically involves weaning off the offending agent and replacing it with another that is later weaned off, combined with a more long-term solution. This should be done under strict guidance by a specialist, preferably a headache specialist, or else the headache will not improve and withdrawal side effects can occur.

It looks like you have had these headaches for 7 years with a predominantly unsuccessful treatment regimen. I would highly suggest you be seen by a headache specialist (i.e., a neurologist who has been trained additionally in treating headaches).

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.