I have a friend 42 yr old male that had a snowmobile accident 3 yrs ago and since that accident he has had continual headaches. This is a person that had done well in his life was a pillar of the community and in the last 3 yrs since the accident he has not been able to hold a job because of the headaches. He has no insurance due to no job. Has had numerous cat scans and mri's to no avail. We are at the end of our rope here trying to figure out what to do. Obiviously there is a problem and we will do whatever we have to get him the help needed but we need more direction. He worked for a month and was off 3 days because of the headaches. Please help!!
Your friend probably has cervicogenic headache as a result of his accident. Cervicogenic headache occurs because of trauma to nerves in the neck region. The trauma doesn't need to be severe in order to cause debilitating pain. Many times, the traumatic lesions are not visible in MRI or CT scans, which only serves to make identifying the cause of pain even more difficult. I had a small tumor removed from a cervical nerve, and have been in pain for 29 years, losing my job 3 years ago because the pain became to great to endure. None of my lesions have ever been seen in radiographic imaging. For many, identifying the cause of the pain is less important than finding effective therapy, and luckily there now are many options for treating the pain your friend is enduring.
His best bet is to visit a pain clinic, preferably one affiliated with a major teaching hospital. Newer meds (such as Neurontin, Lyrica, Keppra, and Cymbalta - to name a few) are very effective for many patients. Combinations of these meds are often even more effective because each works in a different manner. Be wary of long-term narcotic treatments, not so much because of the (relatively low) risk of addiction, but because in the long run these drugs can actually cause more pain by inducing the body to "sprout" many more nerve fibers.
Nerve blocks may be useful both for therapeutic as well as diagnostic purposes, and some procedures involving cutting or ablating nerve endings may be successful. However, such "trigger point" techniques generally do not work well for diffuse pain syndromes.
Morphine pumps and implantable electrical stimulation may be necessary for very difficult cases, but these treatment methods are generally riskier than pharmacological treatment.
As you can see, many options exist for your friend. I recommend his next step be to visit a pain clinic, as the doctors there tend to stay current on treatment methods.
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