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Neurology (Expert Forum)
Burning head pain
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Burning head pain
by tired1, Mar 28, 2007 12:00AM
I have burning pain in the back lower part of my head. Has been on the right side for months but now on the left also. It actually originated in the upper right side. The pain is constant (about a 4), with bouts of horrendous pain at times. I've tried to track it but there seems to be no rhyme or reason when it gets worse. Also, I just feel blah. By the end of the day it's WORK to put one foot in front of the other. I've been on Zetia for awhile but can't find anyone that says it could be a side effect.
Doctor's Answer
by Forum-M.D.-SH, Apr 21, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms that you describe are non-specific, but are most consistent with occipital neuralgia. The occiptial nerve emerges around the area where the skull meets the neck (one on each side) and is often compressed or otherwise irritated causing pain, burning and often triggering headaches. An experienced headache doctor could palpate the specific spot and it is often tender. The first thing to do to address this problem is to get an MRI of your Cervical spine and brain. Many disordrs of the neck can cause symptoms like you describe (including occipital neuralgia) and thus this is the first place to look. Anyone with vague headpain/headache complaints should also have an MRI of there brain to settle the issue of possible structural lesion (such as tumor, vascular malformation etc) although most of the scans are normal. If your scans do not reveal anything significant (fairly common) then I would suggest medications that help neuropathic pain such as neurontin, lyrica, cymbalta, elavil, etc. and neck physical therapy. In cases were occipital neuralgia can be clearly defined then trigger point injections (with Marcaine and Kenalog) can provide additional although temporary relief. I would recommend that you see a neurologist that specializes in headache to help you in this pursuit.
I hope this has been helpful.
The symptoms that you describe are non-specific, but are most consistent with occipital neuralgia. The occiptial nerve emerges around the area where the skull meets the neck (one on each side) and is often compressed or otherwise irritated causing pain, burning and often triggering headaches. An experienced headache doctor could palpate the specific spot and it is often tender. The first thing to do to address this problem is to get an MRI of your Cervical spine and brain. Many disordrs of the neck can cause symptoms like you describe (including occipital neuralgia) and thus this is the first place to look. Anyone with vague headpain/headache complaints should also have an MRI of there brain to settle the issue of possible structural lesion (such as tumor, vascular malformation etc) although most of the scans are normal. If your scans do not reveal anything significant (fairly common) then I would suggest medications that help neuropathic pain such as neurontin, lyrica, cymbalta, elavil, etc. and neck physical therapy. In cases were occipital neuralgia can be clearly defined then trigger point injections (with Marcaine and Kenalog) can provide additional although temporary relief. I would recommend that you see a neurologist that specializes in headache to help you in this pursuit.
I hope this has been helpful.
Sometime I recommend switching a ptient with myopathy (Muscle weakness/ cramps) on statin to Zetia...though its said to cause myalgia, back/ joint pain and sinusitis ( did you pain start after Zetia?)
In any new onset headache its crucial to mention the age, a recent weight gain, any hurbal or over the counter meds, is the headache is progressive , associate with nausea, vomiting?, blurred vision, tearing, or stuffy nose? any night episodes, awakening from asleep, or worsoning upon awakening in the morning, or any effect of posture on it (does the pain get worse on bending down or moving the neck, blowing your nose/cheeks, or in the contrary is it worse on lying down...have you tried any type of analgesia and how often/day.any pain touching the back of your head? any relieve if massaged it? then any family history?..Sorry for all these Qs .. I'm a retired neurologist and I try to help here in my spare time
Bob
I do not has knowledge of basilar invagination but I have coped with a rare condition affecting the same area of the body. I have os odontoideum--a softening of part of C2--that caused instability at C1-C2. I had a fusion ten years ago.
It is very difficult and frightening to have a rare condition. Most people can't understand and doctors can be way too interested and eager to treat you because you will be the only patient with the condition they've ever seen. My advice to you is to seek help from the best doctors you can afford. This truly is the time to go to the Mayo Clinic or Cleveland Clinic even if you have to borrow money to pay for the trip. You can also ask for an opinion using the films your doctors have already done.
I was treated at a university-hospital...and had to fight to get insurance to cover the treatment outside my medical group. But if I had to do it again, I would have worked to find and see the best surgeon in the country.