I've had this pain for 8 years. After an MRI scan my Doctor diagnosed muscle spasms due to a bulging disc. Sometimes the pain would be bad but it would fade after taking Paracetamol and Naproxen. Other times it would be faint so I kind of got used to it. During last 2 weeks the pain has worsened & pain killers aren't working. The pain has spread further up the back of my head, down the right side of my face & around my temple. Today my Doctor said that it is also nerve pain. As I am already taking Amitriptyline he advised me to increase my dose. I am reluctant to do this because I already feel very groggy & tired the following morning after taking it.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
Causes of neck pain associated with headache are cervicogenic headache and occipital neuralgia.
Cervicogenic headache is a headache that is "referred" to the head from bony structures, muscles, and other soft tissue in the neck and shoulders. Symptoms are usually one-sided and include: precipitation of head pain by neck movement or awkward neck positions, head pain when external pressure is applied to the neck or occipital region, restricted range of motion of the neck, and neck, shoulder and arm pain. Treatment for cervicogenic headache includes physical therapy, medications (one being the one you are currently taking), behavioral therapy, and other modalities.
Occipital neuralgia is caused by irritation or injury to two nerves that run from the upper neck to the back of the head. The irritation could be due to neck trauma, pinching of the nerves (by muscles or arthritis), and other causes. Symptoms include a piercing sharp pain that travels from the upper neck to the back of the head and behind the ears. It is usually a one sided pain but can be on both sides of the head. Treatment includes physical therapy, medications, and in some cases injections, "nerve blocks", during which a physician injects the irritated nerves with an anesthetic.
I suggest you follow up with your physician. There are many medications that can be trialed. If you are not tolerating the current medication, you may need to change to another one. If the pain cannot be controlled medically, you may need a referral to a neurologist or pain specialist for further diagnosis and treatment.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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