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Do I need to see a neurologist?

Hello. I'm a 23 y.o. female in good health. I do suffer from GAD and have a hx of migraines/tension headaches.  For the past few months I have been under a lot of stress and I have noticed an increase in migraines ( going from once or twice a month to once or twice a week). I went to my doctor and she told me that the migraines were due to stress and prescribed a muscle relaxer and Imitrex.   The migraines have reduced since then. I think I have had about 3 in the past 4 weeks, but now I'm have this intense pressure, tightness in my shoulders, neck, and back of my head.  Sometimes it's so tight that it makes me dizzy. This has been going on for almost 2 weeks. It's a constant pressure and tight feeling.  Sometimes it's dull and other times it's very intense. I went to see another doctor today for a second opinion and was told it's just tension headaches.  He asked if I wanted to see a neurologists and I asked if he thought I needed to and he just said that "it's left up to me".  He seemed kind of rude and didn't really take me seriously.  I have been taking the muscle relaxers and trying to do exercises to ease the tension but it is not working.  I don't want to keep running to different doctors unless it's necessary.  I had an MRI done on my head about 3 years ago and everything was fine.  Do you think I need further testing with a neurologist or try something like massage therapy to help ease the pain?
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Avatar universal
I am sorry that you are in so much pain. You might also want to consider finding a good chiropractor. Mine has done wonders for my migraines by treating my neck.

I hope this helps,
achilles2
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Avatar universal
Salt Lake City Neurologist
http://www.wna-pc.com/
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Avatar universal
If you live in Utah a Salt Lake City Neurologist might be helpful although I agree with the others about massage therapy. I especially agree with the comment about peppermint oil! My niece gets excruciating headaches and peppermint oil always helps bring the pain down although it doesn't completely remove the pain.
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Avatar universal
Hi,

Massage therapy is certainly a good idea since your symptoms seem to be due to muscle spasm in the scalp and shoulders and neck.
Massage will help in easing tension in the muscles. The possibility of these symptoms being due to neurological lesions is quite less because you do not have any neurological symptoms apart from headache. So seeing a neurologist at this point will not help.
If the massage therapy, muscle relaxers and Imitrex do not work then maybe you can think of seeing a neurologist. I would also suggest you to take magnesium and B complex supplements and do some deep breathing exercises everyday.

Keep us posted.

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768044 tn?1294223436
Hi there!

I don't know where you live... so I'm not really sure what to suggest...

In Canada, where I live... they usually only refer you to a neurologist for headaches if an X-RAY/CT/MRI comes back irregular, if your GP thinks your case is too complicated, if you suffer from 15+ headache days per month OR if you have been to the ER for severe head pain (regardless of what the scans showed).

I went to a neurologist for the first time after having a diagnosis of migraines for 4 years and after they had become chronic (15+ days a month) for three months. In Canada, it takes months to see ANY neurologist (not one you get to pick, just ANY neurologist that is available)... so, I was on a waiting list for a very long time... until I went to the ER... then I got bumped up to see one after my ER visit... a week after I got out (otherwise my appointment would have been months away). (<- Canada has an absolutely amazing health care system when it comes to general health care and emergency health care, no matter who you are, you can get treatment at anytime, pretty much anywhere... but it takes months or years to see a specialist here... even if you have cancer or need a muscle re-attached or something... friends who have had breast cancer have had to wait months for biopsies and then months for surgery and friends who have needed surgery for sports injuries have had to wait years... we have a funny system here... but a good way to cut through the red-tape and get bumped up on any waiting list here is to take a trip to the ER... just in case you do live in Canada and are frustrated with your appointment date... that's a little hint... don't use it unless you need it though... only go when you actually have a severe 8+/10 headache)

So... at this point... do I think a neurologist would help...? Probably not... because... like... you've already had the MRI done... and I'm sure your family doctor has done a basic neurological exam (if not, then maybe it's worth it to go... a neurological exam is where they test your reflexes, shine a light in your eyes to test your pupil responses and ask you questions like what city you're in). Then... a neurologist will just put you on migraine medication for acute therapy... which you're already on (imitrex)... and if you DO get 15+ migraine days per month then a preventative therapy which is either: an anti-depressant, an anti-seizure medication (that's what i'm on) or a beta-blocker. but, they really tend not to do the preventative thing if you don't get more than 15+ migraine days per month... and it doesn't sound like you are getting that many (which is really good!!!).

BUT!!! If you are being offered the opportunity to see an neurologist and you want to get an opinion from them, then why not... unless it's going to cost you a lot of money or something... then at this point, just from the symptoms you've said, then I don't think it is completely necessary... but, it's up to you (and your referring doctor) like your doctor said... and I don't think it would be a waste of time AT ALL... I think that just the peace of mind you'd get from it would be worth it... knowing that nothing serious is wrong is always a good thing. :)

Some things I WOULD suggest:

- Your suggestion of massage therapy is a GREAT idea. :) If you find that it triggers migraines... then don't keep going. BUT! Massage therapy can really help for a lot of people. Try it out! I find it helps me. It can trigger it sometimes.. but it also helps most of the time. Make sure to let the massage therapist to know that's what you're going for.
- Other treatments like acupuncture and physiotherapy... some people find those useful. I do physio, I find it helpful. Some people find acupuncture very helpful.
- Vitamin B2 @ 400mg a day. This has been proven, in scientific double-blind clinical trials, to be just as effective as some of the anti-seizure medications that are prescribed as preventative medications. If you are having migraines, this will be very effective at reducing your migraine days.
- Magnesium @ 400mg a day. If you are having tension headaches this might be helpful. If you are having migraines this might also be helpful.
- Muscle rubs and patches that are sold in the drug/grocery store for sports soreness and pain... I find that putting these on my neck or upper back if I have sore muscles or "trigger points" associated with my headache REALLY help the headache. Peppermint oil on your temples, around your hairline, on the back of your neck and on your stomach and help with this too... especially for migraines.

Hope that info helps. :)
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