Pain in back of head....

[yhvhis]

  Hi, I've been struggling for some time now with head symptoms, which seem to be originating from the back of my head.  I get frequent headaches of various types, but more and more I'm having a constant sense of pressure in the back of my head, which feels as if it is being pinched and squeezed.  I sometimes become dizzy and often feel lightheaded, as if enough blood or oxygen is not reaching my brain, it makes me feel tired and confused.  For about two years now I have gotten intermittent sharp stabbing or throbbing pains in the back of my head, mainly on the left side, sometimes reaching from the left back of the head down into the area or the first vertebra.  Lately the pressure has become more constant and I have started to have sore spots on my scalp and in particular two painfully tender areas.  The two spots are symmetric, one on the left and one on the right of the back of my head, each about and inch to the side and slightly lower than the prominent lymph nodes on the back of the head.  If I press on these spots they become more sore and the sensation of squeezing/pressure becomes greater.  I have now had them constantly for the past six days.  As background information, the stabbing pains really started in earnest about two years ago during a fit of anger and have continued off and on since then.  Sometimes I have had strange sensations in my limbs, such as a sort of numb sensation, similar to a growing pain concurrently with the pains in the back of my head.  I may have TMJD, I haven't sought diagnosis, but I have an underbite and crossbite and popping and tightness in my jaw.  Also, chiropractic adjustments have sometimes lessened or temporarily relieved these symptoms, but resolution has not been reached.
My question is, does all of this seem to be vascular, muscular, spinal, or neural in nature?  What would be the most likely condition to look for.  I'm not sure whether to go to a neurologist, a dentist, a chiropractor or what else.
Thanks!
Nick

[painkiller99]

Your symptoms could suggest nerve impingement or cervical spondylosis, but nothing is certain.  I would advise you to consult a neurologist to properly assess your symptoms and possibly to have an MRI done.

[jcverive]

You may have more than one thing going on, but the sharp, stabbing pains are a hallmark of nerve trauma. And as 'painkiller99' suggests, the locations of your pain are typical of cervical spine nerve impingement or spondylosis, so it would indeed be advisable to see a neurologist. I'd advise seeing the neurologist before another chiropractor visit. If there is damage or misalignment to your spine, chiropractic manipulation may worsen things, and the results can be permanent. As a moderator of a neuralgia group/community on Yahoo, I've heard several tales from people who report being injured during chiropractic manipulations when an underlying neurological condition was present. Please ask the neurologist if further chiropractic manipulations would be advisable.

You probably will end uo having X-rays and MRIs performed on you, but don't be surprised if the tests are negative. Many neurological conditions do not show up on these tests, though your neurologist may interpret negative or "unremarkable" tests to mean that you do not have any nerve trauma.  You may be told that you have "complex (or complicated) migraine" instead, which seems to be the catch-all diagnosis for head pain without X-ray or MRI findings. The bottom line then is to find a pain doctor or pain clinic interested in treating you based on your symptoms rather than a fall-back diagnosis from a neurologist not specifically trained in pain management.  Best of luck, and please consider updating us on your progress.