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Positional Headaches
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Positional Headaches


  I injured my lower back (pulled a muscle) 4 years ago and about 2 months after I began to get a very severe throbbing in my head after I would straighten up and after bending down to pick things up off the floor or to brush my teeth.  It also happens when I sneeze, get up out of a chair, laugh very hard, and other various times.  The pain starts in the lower back of my head, and radiates up to my temple area.  I have had MRI's, X-rays, physical therapy, etc.  Nothing helps.  I am now taking Neurontin to attempt to control the pain.  I have heard of positional headaches so I wanted to get some more information on this type of headache.  One thing that did help is a nerve block that was given by injecting it into the back of my head, even with my ears almost.  The pain was gone for only 3 days and I was very nauseous and dizzy afterwards for weeks.  So I can't receive any further shots.  I have a lot of trouble sleeping as my neck always hurts.  Only on the right side.  Occasionally I will get twinges of pain up the right side of my neck that go up to my temple area.  The only way to relieve this pain is by applying ice.  I am a graduate student and much do a lot of reading and I have trouble bending my head down to read so must prop books up.  The worst pain causes me to feel nauseous.  The intense throbbing sensation that I feel when I get up from a bending position lasts for about 5 seconds.  After that, I feel very little pain.  My neck is always stiff and sore and my back has permanent knots of binded muscle all up and down my back.  Sorry for rambling.  I am trying to get everything in so you can get a good idea of what is going on.  Could it be that when I pulled or tore the muscle in my lower back that when it healed it pinched a nerve or in some way affected a nerve that is "pulled" everytime I stretch my back?  In essence, that is what I am doing everytime I come out of a position that causes this pain.  It is always some sort of stretching out of the back (as I arch over).  Any ideas would be so appreciated.  My activities are severely limited and sometimes I feel like a pharmacy with the number of different drugs that have been prescribed.  One more thing.  I was taking Tegretol for this pain and I believe it helped somewhat, but the side effects of lethary and dizziness were intolerable.  Thank you, Christina Schelling
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Dear Christina:
Your description may indeed fit with syndromes such as occipital neuralgia or cervicogenic headaches. these are best treated with local nerve blocks in the point on the back of the head that tends to trigger the pain. I do not understand why you should have had the prolonged unpleasant reaction after that single procedure, which apparently did help for a few days. I would suggest that you consider persevering with more local occipital nerve blocks, if your doctor thinks it is appropriate.
Good luck!




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