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Scalp soreness and headaches
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Scalp soreness and headaches

I have had conststent aches throughout my body for months now.  Back pain, neck pain and stiffness, chest pain, major scalp pain, and daily headaches.  I was told by my physician that it could be fibro.  I just wanted to get a second opinion because I feel too young to have such a problem.  I am only 22.  

Do you have any suggestions of how to limit or treat my headaches?  Tylenol with caffeine seemed to have helped a little, but I can no longer have caffeine because I have interstitial cystitis.

Please help.  It has really affected my work and everyday life.
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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 cause of your pain is nor recommend specific treatments. However I will try to provide you with some general information.

Diffuse aches and pains with headaches can be caused by several things including but not limited to thyroid problems, vitamin deficiencies, certain muscle problems, and certain medications. If you have had an appropriate work-up including an MRI of your brain and basic blood tests, and a cause is not found, it is possible you have a primary headache disorder (a headache problem without a specific structural cause). Fibromyalgia can occur at any age, and is seen in women in your age group.

There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. Secondary headache disorders are due to an underlying problem, such as a tumor, medication side effects, central nervous system infections, clots in the veins in the brain etc.

There are several primary headache disorders, over 50 different types.  For example  migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. Tension type headaches are a dull pressure-like sensation that can be either at the back or the front of the head or global. A common cause 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.

In treating chronic headaches such as in yourself, the treatment should include two types of medications: preventative therapy and abortive therapy. Preventative therapy is a medication that would be taken every day regardless of whether or not a headache is prevent. This type of medication is used to prevent headaches from occurring, and there are several types including but not limited to beta blockers such as propranolol, calcium channel blockers such as verapamil, and others including topamax, depakote, elavil, etc. A lot of these medications were invented for other uses and are used not only for headache but also epilepsy and depression. They have proven very effective in preventing headaches. The second medication is abortive, meaning it is used when a headache is coming on. The medication used depends on the nature of a headache. If it is a migraine type headache, a group of medications called triptans can be used. And so on. However, with frequent use of abortive medications including triptans, tylenol, advil, and others, medication overuse headache occurs. This requires a specific treatment in which the over-used medications are slowly stopped and replaced with more long-acting medications. Tylenol with caffiene, and similar medications, can cause medication overuse headache if used too frequently. Lyrica, which is used for fibromyalgia, can be used for chronic headaches too.

Causes of neck pain associated with headache are cervicogenic headache and occipital neuralgia.

Cervicogenic headache is a headache that is "referred" to the head from bony structures, muscles, and other soft tissue in the neck and shoulders. Symptoms are usually one-sided and include: precipitation of head pain by neck movement or awkward neck positions, head pain when external pressure is applied to the neck or occipital region, restricted range of motion of the neck, and neck, shoulder and arm pain. Treatment for cervicogenic headache includes physical therapy, medications, behavioral therapy, and other modalities.

Occipital neuralgia is caused by irritation or injury to two nerves that run from the upper neck to the back of the head. The irritation could be due to  neck trauma, pinching of the nerves (by muscles or arthritis), and other causes. Symptoms include a piercing sharp pain that travels from the upper neck to the back of the head and behind the ears. It is usually a one sided pain but can be on both sides of the head. Treatment includes physical therapy, medications, and in some cases injections, "nerve blocks", during which a physician injects the irritated nerves with an anesthetic.

Fibromyalgia and chronic headaches are often associated with depression and anxiety. Treatment of depression and anxiety with medications such as anti-depressants can often help improve the headaches as well.

If you have not seen a neurologist yet for your headaches, that would be a good idea You may also benefit from evaluation by a headache specialist.

Thank you for using the forum, I hope you find this information useful, good luck.

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