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655242 tn?1229476344

Strange headache

Started with neck pain, muscle pain, nerve pain, pain going down arms, burning pain under collar bone.  Had an MRI and showed nothing but slight loss of curve in neck.

Then I got a headache (6 days ago)...sometimes it is a throbbing burning at the base of my skull.  Other times it is a weird spot on the back of my head that feels cold.  But the one that hurts the worst is down the right side of my face causing visual disturbances (constant even without the pain).  So...I had an MRI of my brain with and without contrast...Again found nothing.  I have taken ibeprofen, loratab, and aleve and the meds seem to only mask the headache and not totally take it away.  

What kind of headaches am I having?  Why wont they go away even with meds?
69 Responses
449909 tn?1233413497

Your story seems to fit into 'cervicogenic headache'. (Headache caused by problem in the neck) However, correct picture can be gained only by taking your full history, and after an examination of head and neck, and the relevant neurological examination.

Be glad there is nothing wrong structurally (CT and MRI). Now you have to find out what is causing the headache and other pains, and get treatment for the same. Many 'specialists' share the head & neck area, and you have to see some doctor 'interested' in headache.

Cervicogenic headache is managed by neurologists or spine surgeons or orthopaedic surgeons, according to their interests.  Discussion of the treatment modalities is superfluous here.
Best of luck.
Rgds,

Thomas Antony
655242 tn?1229476344
Thank you...I am actually a 27 year old female I do smoke but other than that i am in good health (or at least I was..LOL) and was told by my physical therapist that I have a hypermobil neck.  I did not have any injury but I guess too many trips to the chiro for adjustments might have done it??  I dont know but I know that i am having some serious issues and can now crack my neck just by turning my head.

My doctor is worried about my visual disturbances since I have had flashing/blurred/double vision in the side that hurts.  He is sending me to a neuro optomologist but I have to wait until Dec and I am hoping the heache and other stuff will be gone by then...a month is a long time to be in pain!!!

I guess maybe I should try and schedule a regular neurologist appoinment sooner?
654968 tn?1304363030
Oh my god sounds like me in many ways. I have had a constant headache for 4 solid weeks. It's driving me nuts. Been to doctors several times. Had a MRI 2 years ago so she has said that she is very reluctant to send me again. Doctors are convinced it's my neck. I now visit a Osteopath, who has said it is my nect, one session in and I still have the headaces.

I am worrying about them even though I should be happy that there isn't something wrong with the MRI scan but why am I getting these headache, why doesn't someone know the answers. The doctor has suggested that my anxiety is keeping the headaches going. Who knows ay.....

Kathy
Avatar universal
Hi,

Thanks for writing in.
The cause of your headache seems to be in your cervical spine. It is important to undergo a complete cervical spine examination. In the meantime I would suggest you to do some gentle neck exercises, make sure you always have a good posture while watching TV, reading, sitting or lying down. Neck massage and ice packs will also help you.
Also get yourself evaluated for migraine, since you have visual disturbances also along with the headache.
Take care!
655242 tn?1229476344
Thank you doctor.  I actually like heat better for my neck...is that bad for it?

Kathy- Sorry to hear you are going through this too.  I agree with your doctor about the anxiety keeping the headache going...I have anxiety too and I think it is contributing to mine as well.  Lets both try to relax since our tests have come back fine!

I have been trying everything from ice packs on neck, heat on shoulders, massaging knots in neck and shoulder out with tennis ball, massage face, meds for sinuses, antibiotic (I know that is not good to take when you are not sure you have an infection), and then all the pain meds.  I am running out of options here!!!  Is there anything you have found helps the most?
449909 tn?1233413497
Needless to say, you have to stop smoking, though it seems to have no
express connection with your headache. (Or one can stretch one's
imagination ;-) and see the nerve endings of trigeminal nerve in the nose
and sinuses getting stimulated/ irritated; a further stimulus from the neck
may be causing the headache? No specific research on this done so far, as much as I
know.

The upper three cervical nerves (the ones coming out of/going into  the
spinal cord) are connected with the nucleus of the "trigeminal nerve" of head,
in the upper part of spinal cord. This is the reason why something in the
neck can cause headache.

Hypermobility of the neck is known to produce cervicogenic headache. I think
(since it is not my specialty) they advise neck exercises to strengthen the
muscles so that the neck is held steady (even when you are not aware of
it)and keep the neck-vertebrae and muscles in alignment.

Try holding the neck steady while walking or sitting. The posture is
important. (You must have seen how the models do it on the catwalk. Chest
up, chin down).

I think a physiotherapist can help. If you want an MD for advise, it is the
spine surgeon, orthopaedic surgeon, neurologist or the physiatrist.
==============================

And a word to kathyanne100

In headache, it is sometimes difficult to get the right answer immediately. This is
because the how-and-why information regarding headache is so huge. Thats why
there are a number of professional journals dedicated to the subject, and a lot of papers on the headache appearing each year for on the same.

But don't loose heart. I am sure you will find help.

Best,
Thomas Antony
655242 tn?1229476344
Thank you for your help!!!

I am working on quitting smoking...this is a hard thing to do but I am def trying.  

Yes I have a list of exercises that I have been doing for my neck (only been about 3 days) my physical therapist gave them to me since this all started in my neck that was the first person I was referred to.  Chest up and chin down....I will practice.  I thought about asking for a referral to a physiotherapist so I could get accupuncture or something.  I guess i will still start with the neuro though.
449909 tn?1233413497
Best of luck !

TA
654968 tn?1304363030
Thank you for your comments on my condition.


I have suffered with 'Health Anxiety' for years.

I have been getting headaches for 4 weeks, fairly mild to mod along with itchy scalp 'creepy crawly sensation on my scalp, very mild now, which doctor said is anxiety. I have taken every pain killer on the market but none work. I have been to the doctor 5 times 2 different doctors who have both said that it is 'tension headache' that is being kept going by my anxiety. I had an MRI scan 2 years ago because I was getting headaches then, which was all clear apart from an old sinus infection. The brain consultant said that there was evidence of Migraine headaches and that was it. 2 years later it's happening again. My doctor has said that she would be very reluctant to send me back for another MRI scan. She has told me to try and relax and work on relieving my anxiety. I am on anti-depressants 'Prozac'. This doesn't seem to be doing much for me.

I have received CBT 'Congnitive Behaviour Therapy' last year which seemed to work. When I get a real symptom like a headache the worse case sceniro kicks in like maybe it's a 'brain tumour' and i can't get it out of my head. I worry myself into a nervious wreck. I don't know what to do anymore.
I have been to a Osteopath who has said that my neck is very out of place, he worked on it, and for two days NO PAIN IN HEAD, Day after headache back. I have visited the Opticians who said I need stronger reading glasses but my eyes nerves etc looked very healthy. I feel like I am ticking off all the possible things it could be. I am going back to see the Osteopath on Tuesday as he said he would like to do a bit more work on my neck and back as it was quite bad..  I realise I can't have a brain scan everytime I get a headache. I seem to need reasurance on every level when I get like this. I am driving myself and my family absolutely MAD...

I would love your advise on this situation. I try so hard to ignore the headache and get on with my life but it's constantly there in the background and is making me aggitated.

I need some sort of relief. I have also tried 'forehead', absolutely no good for me. Doctor said that nothing would work because I keeping it alive with the constant worrying over it, one is feeding the other.

Please can you help with some advise? I would really appreciate it. I want to believe my doctors.

Kathyanne



654968 tn?1304363030
Thank you for your reply to my message. I can't stand it anymore. I am convinced it's anxiety headache, but just sometimes I trip out and think 'brain tumour' can't help myself. My doctor has said that because I only had a MRI 2 years ago she would be very reluctant to send my for another, and to be honest I don't want to go for another.

Every now and then I am terrified that I am ignoring a real symtom of something serious. I can't seem to remember what the doctor has said time and time again to reasure me.

Oh well, I just keep going, no other choice ay/

Kathy
655242 tn?1229476344
I have health anxiety too...I go to the ER every time thinking I have an anuerysum, tumor, cancer, stroke, heart attack...basically anything bad you can think of.  Mine was a lot better when i was on zoloft but I just stopped taking it about 3 months ago and now my good old health anxiety is back.  I dont want to take the zoloft again because i lost about 20 lbs getting off of it and I feel like I look great...just dont feel great...LOL

You said..."Every now and then I am terrified that I am ignoring a real symtom of something serious. I can't seem to remember what the doctor has said time and time again to reasure me"...This is literally the EXACT same thing I think!!!!!!!!!!!  I just keep thinking I cant ignore the symptoms because what if it is something bad and if it is better to catch it early so I dont die...Or I think what if the doctor is missing something.  I went through a really bad spell of this when i was about 18 and I slept with my mom every night and was scared to go to sleep cause I did not think I was going to wake up.  I was terrified something was bad wrong with me and guess what...it was NOTHING!!!!  I did not eat or sleep for 3 months.  I really dont want to get like that again.  My dad is the most laid back person I have ever met and always says "Why do you worry about everything all the time?"  He says I should just live my life and if something bad happens then it happens but cant always be scared of everything or you dont really live.  He said my grandmother always told him to just pray and leave it all to God.  I really do feel like I am wasting my life!!!!  Constantly worried and anxious and not able to just have fun!!!!

Just out of curiosity...do you remember what started your health anxiety?  Mine started when my grandmother passed away...she was my favorite person in this world and I thought she would be here with me forever!!!  She was 92 when she passed but I still was not ready.  I wish I could be more like her because she never worried about anything!  

Now I have a 4 year old little girl (my new favorite person in this world and my little angel) and cant even enjoy my time with her cause I am constantly worried about my health!

Lots of love to you and good luck!!!

654968 tn?1304363030
Thank you for your thoughtful kind reply. You have it tied up in a big red bow, for want of a better way of putting it. Yes we are wasting our lives, not meaning to but doing it anyway.

I think I have always had it to be honest. Bad childhood, etc etc. Doesn't help does it. Watched my Aunt die of Cancer when i was 10 years old, she lived with us and was dying. I can still smell cancer. I am fine until I get a syptoms and then my world comes to a halt and I do everything to punish myself almost. Don't eat, sleep.

I am so fed up that I feel this way. I am constantly feeling what if I miss something, or the doctors miss something.

Keep in touch,

Love Kathyx
655242 tn?1229476344
I am so sorry to hear about your aunt, that must have been a hard thing for a little girl to see and go through.  I am sure my health anxiety would be even worse if I had of seen that as well.

Well we have to find a way to make it stop...we have to find peace in ourselves so we can stop doing this.  We are only hurting ourselves and wearing down our immune systems making is easier for us to really get sick.  

If you figure something out you let me know and I will do the same cause right now I dont think there is enough xanax in the world to keep me from doing this...LOL

:)
Laurin    

  
655242 tn?1229476344
This headache is starting to make me mad...now I have some discoloration under the eye that is blurry.  Looks like a bruise...what in the world could that be???

Could it be a sinus headache and causing this discoloration?  I massaged my neck all weekend and may have overdone it cause I am hurting pretty bad today.

Any suggestions about the eye thing?
449909 tn?1233413497
I will attempt to give my thoughts:-

I have suffered with 'Health Anxiety' for years.

I have been getting headaches for 4 weeks, (?Only four weeks?) fairly mild to mod along with itchy scalp 'creepy crawly sensation on my scalp, very mild now, which doctor said is anxiety. I have taken every pain killer on the market but none work. I have been to the doctor 5 times 2 different doctors who have both said that it is 'tension headache' that is being kept going by my anxiety. I had an MRI scan 2 years ago (That will not give the present brain-picture. Maybe you had the SAME quality of headache then?)  because I was getting headaches then, which was all clear apart from an old sinus infection. (? Old sinus infection; how was it concluded upon?) The brain consultant said that there was evidence of Migraine headaches and that was it. 2 years later it's happening again. (A ‘migraine headache’ after a symptom-free interval of two years?)  My doctor has said that she would be very reluctant to send me back for another MRI scan. She has told me to try and relax and work on relieving my anxiety. I am on anti-depressants 'Prozac'. This doesn't seem to be doing much for me. (Prozac is an antidepressant, and you require an anti-anxiety drug, something like a Benzodiazepene; may be Alprazolam?)

I have received CBT 'Congnitive Behaviour Therapy' last year (?Last year? For What?) which seemed to work (?Work for what?). When I get a real symptom like a headache the worse case sceniro kicks in like maybe it's a 'brain tumour' and i can't get it out of my head. (Brain tumour will show up with many other different things before headache appears) I worry myself into a nervious wreck. I don't know what to do anymore. (Headache precedes the ‘worries’ or worries precede the headache?)
I have been to a Osteopath who has said that my neck is very out of place, he worked on it, and for two days NO PAIN IN HEAD, Day after headache back. (Anxiety can put the neck muscles into spasm and can thus cause a headache; alternately, a depressed mood can result in a forward head position, leading to the same “cervicogenic headache” I have visited the Opticians who said I need stronger reading glasses but my eyes nerves etc looked very healthy. (Refractive error – the lens errors of eyes, has been known to produce headache, and my neuro colleague had remarked about neck muscle spasm too. So if the ophthalmologists feel you need a change of glasses, why don’t you go for it and see?) I feel like I am ticking off all the possible things it could be. I am going back to see the Osteopath on Tuesday as he said he would like to do a bit more work on my neck and back as it was quite bad..  I realise I can't have a brain scan everytime I get a headache. I seem to need reasurance on every level when I get like this. I am driving myself and my family absolutely MAD... (It is all part of the game, don’t blame yourself)

I would love your advise on this situation. I try so hard to ignore the headache and get on with my life but it's constantly there in the background and is making me aggitated. (“Agitated”: What exactly do you mean? Did any doctor suggest you with a name such as ‘agitated depression’?)

I need some sort of relief. I have also tried 'forehead', (Sorry, I don’t know what you mean here) absolutely no good for me. Doctor said that nothing would work because I keeping it alive with the constant worrying over it, one is feeding the other.

Please can you help with some advise? I would really appreciate it. I want to believe my doctors.

Kathyanne
======================================================
            Lets go over it again to make sure that I got it right.

Are you diabetic, hypertensive or not? Any other illness now or in the past worthwhile mentioning?

You have a headache for the last four weeks. (what type of pain on which part of head, face or neck? How did it start (sudden?) in the first place? Is it a continuous pain? Or does it come and go? If so, how long does each episode last? What is the severity?  And how many times does it come in a day/week?  Do you see any zigzag lines or some visual phenomenon or anything unusual before the headache (“aura”)? Do you find ordinary daylight or sounds unbearable during a headache? Do you throw up during headache? Any other accompaniment to headache? Is this headache similar to the one you had 2 yr back?

Any episode of unconsciousness?

Creepy crawly sensation on scalp: Sounds like “functional”; how did this start? Is it an accompaniment of the headache? What starts the itch?

What do you think about your mental status? (Other than health anxiety) Do you feel like weeping now and then? Are you more irritable now?

Do you have palpitations or tremulousness? How is your appetite, sleep etc? Do you get nightmares? Are you habituated / addicted to anything? Smoking, alcohol? Monthly periods? Any relation to the headache? What all medication are you on? (whether OTC or prescription)

What findings did your doctor mention to you? How about your BP and pulse rate? (You can check your pulse rate at various times of the day and see)

Hope this helps. Reply at leisure.

Best,

Thomas Antony
654968 tn?1304363030
Thank you for your reply and for taking the time.

No I do not have diabitus, I think I have hypitention as I am a nervious all the time. I do not have any other illnesses.

I have had headaches for the past 4 weeks on and off, nearly every day. They have never been severe headaches, just a  throbbing preasure in my temples and discomfort across my forehead. The ache is only in my temples & forehead mild to very rarely moderate pain. I have had a few pains on the top of my head but again very mild. My neck has been bad that was the reason i went to an Osteopath as he agreed with my doctor that my neck is out of place. He had done work on it and for 2 full days I was PAIN FREE. On the 3rd day the discomfort returned. It is not a continuous pain, I am constantly checking to see if the headache is there, if it's not there it's not long before it arrives after me checking. NO I do not get zigzap lines or disturb vision at all. I have never been unconciousious due to the headaches. I haven't been sick or felt sick throughout. No aura before headaches. When i get up in the morning it's not always there until I think about it. So in answer to your question 'does the headache precede the worries or the other way around', I think I do check to see if the headaches are there, then worry them forward maybe... Lights or loud sounds do not seem to be bothering me.
I do get palpitations but I have always had them since suffering from depression...  I think the headaches are the same as 2 years ago but I can't completely remember. I was sent for MRI scan then because I had visited the doctors 8 times for headaches she had no choice in the end even though doctor didn't beleive there was a good enough reason to send me.  
I think the creepy crawly sensation on my scalp started around the time of the headache but can't be sure. The headaches started in Spain I was there for a few days and on the 3rd day I had a vertigo attack, well that's what my doctor said I had, I felt fine after a few minutes but later in the day I developed a migraine. The dull ache in my head has been ongoing since then. The creepy crawling sensation may have started in Spain after the verigo attack I really don't know. It is very mild now. Dealing with my itchy scalp I changed my shampoo and that did seem to calm it down for a while, it's back but mild. My scalp seems tender to touch, but I think it's from when I was scratcing my head and rubbing it.
I had severe depression 2 years ago caused by worrying over my health. I was referred to see someone who could do CBT... i think I am only irratable now because the dull ache is there and i keep getting scared. I am on Prozac only. I have been for years. I am not taking any OTC pain relief at present because nothing works. When I mentioned 'forehead' it was a herbal rub on medication for headaches. That doesn't work either. Since the headaches i don't sleep very well, because i am constantly worrying, when I do I have nightmares, my eating is on and off. I have never taken illgal drugs. I do not smoke and have never smoked. Nor do I live in a smoking enviroment. I do drink one glass of wine every evening, this is the only thing that seems to relax me and relieve the dull ache. I don't have monthly periods as I had a hysterectomy in 2000. I was left with one ovary as I was too young to go through the menopause. My doctor hasn't mentioned aggitated depression as I have already suffered from depression. I don't know how the consultant concluded the sinus situation on my last MRI scan. When I visited my doctor 2 days ago she read the consultants report out to me from 2 years ago, there were NO findings of abnormalties, no brain leisons. The only thing he mentioned was evidence of an old sinus infection, and evidence of migraine. How he came to the sinus conclusion I really don't know. He offered me some prescription relief but I said THEN what I say now, it's a dull ache in my temples & forehead i don't have to take anything i just wanted to know it wasn't a brain tumour. Soon after he confirmed that I had NO tumours my headache went away completely.
2 days ago my doctor checked my BP and it was completely normal. I think she said it was 125/69 I think that was what she said, she definately said it was perfectly normal.

I really appreciate your opinion, and if you need any further information on my med history please do not hesitate to ask me.

Thank you so much for your help..

Kathyannne
654968 tn?1304363030
Thomas Anthony

I am so sorry but the previous reply was for tomsant in reply to his note.

Sorry for confusion..

654968 tn?1304363030
Just to add to my last description of my condition. My Doctor has said that she believes I have Cervical Spondylitis. This may help you with what is going on with me.

Thank you ..

Kathyanne
Avatar universal
Hi
Pain in the neck can have several causes like bad posture leading to loss of curvature, degenerative diseases, neck arthritis, cervical spondylosis, ankylosing spondylosis, spinal stenosis, spondylolisthesis, etc. Some other causes can be arteriovenous malformation, effect of some medication, diabetes, lyme disease, etc.

Do you have any history of raised cholesterol, raised BP, diabetes or any other medical problems?

You should also try yoga and some mild neck exercises. This will help you maintain a proper posture and alleviate the pain gradually. However, if the symptoms worsen, you should consult a neurologist.

Do write in if you need some other information. Take care!

655242 tn?1229476344
Thank you for your reply.  I am a 27 year old female with no prior medical problems other than Ulcerative colitis (have not had a flare in 4 years), IBS, heart palpitations, and anxiety.  

I am about to start some yoga to try and stretch and relax.  The problem is when I stretch my neck it cracks and seems like I am doing more harm than good.  I have also been using a tennis ball to try and work out some of the knots in my neck but I think I am over doing it because I was really sore today and I have burning pain down my neck where my carotid artery is.  I just dont want to hurt myself worse.  I am also in physical therapy and I have an appointment with a neurologist in December.

Thanks!!!!
Laurin
654968 tn?1304363030
Hope you got my last 3 messages, I am afraid i made a mistake and didn't address it to you directly..

Kathyanne
449909 tn?1233413497
I got them. I just happened to be busy a bit. Have saved them to my pc. Shall reply tomorrow. It is 11 pm now here.

No matter to worry :-)
Best,
Thomas Antony
654968 tn?1304363030
Thank you...

Kathy
449909 tn?1233413497
Hi,

I am taking many things for granted, that you are married, and you have children…. I know it is difficult to lay open one's personal life like a book in the net. This is a limitation. Though this communication can’t replace a formal interview where I can ask relevant questions, to get the correct ‘history’ followed by a clinical examination to make a 3D picture of the situation, we will try to analyze your problem:

1. Headache, you said it started while you were in Spain. Until then you were doing fairly okay, except for depression (you didn’t mention how long) and a past history of hysterectomy. I will assume that you went to Spain about 2 yr back, and there you had the ‘vertigo’ (means you felt an illusion of movement, probably of going round and round) and later a headache, for the first time in your life. You have used the terminology ‘migraine’ and not headache. The doctor gave the label or was it your conclusion? Somehow the description of your headache doesn’t fit into the ‘mold’ of migraine, according to me. You said you doctor has left a note that there is ‘evidence of migraine’? (It just can’t be in MRI) As far as I know, migraine is diagnosed by a “symptom pattern” (your pattern doesn’t look like migraine), and after ruling out other causes of headache. For this one may have to visit various specialists (sadly so) including ENT, Eye and may be Dental surgeon too! With the hope that they know what to look for. It is said that the ‘eyes do not see what the mind does not know.’ So there is a matter of luck here. ‘Headache’ tends to take away a lot of precious time, and may require more than one visit, and the physician’s work may be in vain if the patient continues ‘doctor-shopping’  That may explain why an average physician is disinterested?

2. Anxiety: You said you are nervous all the time, have palpitations, nightmares, creepy crawly sensation in scalp. Do you have startles when a door slams, or at some such sounds? Do your hands tremble? All these can happen in anxiety, but rarely it is caused by the thyroid gland secreting too much hormone. In that event, your pulse rate will be very high. You may prefer a cold environment as well.

3. Depression: Is it depressive feelings or a depressive illness, diagnosed by a psychiatrist? Do/did you find that you are unable to feel happy? Have you noticed any change in your intimate life with your spouse? Do / did you have suicidal ideations? You also mention ‘Severe depression’ Was this the diagnosis given by a psychiatrist or your conclusion? (Agitated depression is a variety of depression) How long have you been diagnosed to have depression?

4. Itchy scalp: Did you mention this to your doctor? What did he/she find? It may be a psycho-dermatosis.
5. You say you have never been unconscious due to headache. Due to what else?

I feel your doctor should give an Alprazolam trial. This will tackle the anxiety (Prozac tackles only the depression) and you will know for yourself how you will feel. If your pulse rate is very high, we have to take a different route. But no harm done by taking Alprazolam.

Please feel free to write.

Best rgds,

Thomas Antony
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