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frontal headache
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frontal headache

I have had a constant pressure feeling in the front of my head and the  top of my head for along time now and no matter what drug I've taken it just won't go away.  I've had MRI and MRA of head and neck and nothing shows up.  I had a benign eye exam and blood tests.  Something I noticed is if someone stands behind me and slightly stretches out my neck (supports the weight of my head and hyper extends my neck) that the pressure disappears.    What do you make out of this considering my brain and neck scans were normal except for mild spondylosis in the neck?   Do you think a chiropractor is the answer?  What is causing my symptoms?
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Dear typobob,

Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms.
I am extremely limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

To begin, the fact that your Brain MRI and MRI of the cervical spine were "normal" is reassuring.
This eliminates the worries of serious spine pathology or brain diseases like stroke or bleeding inside the brain.

If this "constant pressure feeling in the front of my(your) head and the top of my(your) head " is occurring in isolation -- that is, without other neurologic symptoms (e.g. weakness, visual changes, sensory changes, gait problems, persistent nausea and vomiting, etc.) then it most likely is cervicalgia or tension type headache.

To be blunt, no -- I do not think that a chiropractor is the solution to your problem.

Here are my suggestions -- at least some to begin with.
1) Seek evaluation from your primary care physician.  Many PCP's are capable of handling headaches.  Discuss using NSAIDS (like ibuprofen) routinely with or without a muscle relaxant to reduce the tension in your neck.  Because muscle relaxants are sedating, we often prescribe these as once daily dosings at bedtime.
Also discuss referral to a physical therapist, who will show you simple, correct maneuvers to alleviate the tension in the neck area.

2) If this does not help, seek evaluation from a headache neurology specialist.  Our HA specialists at the Cleveland clinic are wonderful and literally work miracles in alleviating pain.  I highly recommend all of them.

Hope this helps,
Best of luck,
JKL, MD
3 Comments
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do you ever have "head rushes" or vertigo?
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Read some of our posts on Cervical Facet syndrome, cervicogenic & tension headaches. Have you seen a headache specialist?
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