Headache-Adviser.com

Daily Head Pain

by J
(England)

Sources of Headaches

Sources of Headaches

Hi Mary Kay

I have had this horrible daily Pain on my skull just behind my ear, everyday for the last 2 years. when i look at skull diagrams on the internet it seems to be the area on the skull that is called the 'occipital bone' / Mastoid process

the pain tends to be a dull aching pain on my skull just behind my ear. sometimes its a sharp burst of pain too.

i went to the doctor, physio etc etc, went for 2 MRI scans, met a Neurologist, thankfully they found nothing on my MRI scan and they gave me propranolol tablets to take which made me feel so tired and lazy and i have to be alert at work so i stopped taking them.



I have learned to live with the pain (even though its a horrible daily pain) - sometimes when its really bad i take pain killers and the pain goes away but then it always comes back the next day. The pain is usually worse if i have taken painkillers the day before.

I hurt my back the other day and the doctor gave me anti inflamatory diclofenic sodium tablets - they were great and made the heachache go whilst i was taking them but i stopped taking them and the headaches are back again. That would imply that it is something inflamed on my skull behind my ear?

My case with the doctors has gone cold case because i have almost given up with it and just learnt to live with the pain, but the last few days the pain has been really bad so i thought id look on the internet and i found your amazing site where i read about occipital headaches and i learnt more about it just from reading stuff on here than i have learnt in the last 2 years of seeing all the doctors where i live in england

The only thing i can think that might have caused it is 2 years ago i took quite a bit of viagra one week and it gave me these headaches the next day that would usually go away, and then one day the headache just didnt really seem to go and i think this is still the headache i have now

is this possible?

could the viagra have inflamed something on my skull behind my ear? the 'occipital bone' / Mastoid process area is where it hurts

what can i do?

what can i take to get rid of this pain? i am so sick and fed up of it

I really want to find a cure mary kay!

Do you work in the united states? I live in england

thanks alot

best regards

J

Answer

Hi J,

First of all yes, I only practice in the US and am licensed in the state of New York. I did some research for you and found a list of the headache centers in the UK. This list of sites includes the Migraine Center in London which is charity based and also does research. If you have not seen a headache specialist I would recommend you consider this.

It seems like many headache centers in the UK are labeled "Migraine Clinics". Don't let this put you off, they see all types of headaches. Here in the US we call them "Headache Centers".

Your symptoms do sound like a form of cervicogenic headache which is a form of neck spasming. It tends to come and go, and responds to anti-inflammatories as is a type of tension headache. Over use of the meds results in analgesic rebound headache syndrome.

You do not mention your age, but if the headache started after Viagra use, one cannot ignore the possibility of a vascular cause to these headaches. Based on this history you should have carotid dopplers done and an MRA of the brain which looks at the arteries.

Start with the headache specialist and good luck!

Mary Kay Betz MS RPA-C

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Headache For One Year

by barb
(croswell mich)

I got up one morning an had a headache an it has never gone away. I have good days an bad. I pack my head in ice a lot to help with pain. Nothing helps with the pain. I have been tp ten different doctors an nobody knows what it is. I have given up an figured I would have to live with it. Things are getting worse; I now get dizzy too. Any clue how I can get it to go away? I have tried 20 different kinds off medications. Should I just give up an live with it?

Barb

Answer:

Hi Barb,

A sudden onset of a headache in someone who has not had them before could be what is called "New Persistent Daily Headache" which is rare. I will assume that you have had the full workup including MRI or CT of the brain, blood work to rule out thyroid disorder, anemia and B12 deficiency, all of which are medical causes of headaches, especially daily headache.

The good news is you live in Michigan. I would highly advise that you go to the Michigan Head and Pain Institute in Ann Arbor. They have the ability to do both outpatient and inpatient care for headache which is great for headache patients.

You may have to petition your insurance company to allow this and usually I can get my patients in there by stating that there are no inpatient services for headache in my area.

Good luck!

Mary Kay Betz MS RPA-C


Plz help
Barb

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Headaches everyday

by Melissa P
(Joplin mo)


I am wonderng what this could be? Do I need to get an mri? I have headaches all day every day I tried tylenol it helps for about hour and half then comes back. What could it be im scared to have a tumor or something. I also get dizzy with it sometimes feel sick to my stomach.

Melissa



Answer

Hi Melissa,
Without more information it is very difficult to say what is happening. I would suggest you see your doctor for an examination, and ask if you need to see a neurologist.

Mary Kay Betz MS RPA-C

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Daily Headaches For 12 Years

by Yolanda
(Raton, NM)


Hi,

I have been getting bad headaches for almost 12 years now. I got hit in the side of my head with a baseball and it left a dent in my head for quite a while. Doctors tell me that this isn't why I'm getting my headaches now. That is when it all started.

I have gone to several doctors and specialists but none can help me.

I had a spinal tap done, blood work, MRIs, CT Scans, and still no one knows what is wrong. They all say everything is coming back normal.

I have tried every headache pill, anti-seizure medications, and even blood pressure medications and nothing helps. I know there is something not right because I have these headaches from the time I get up in the morning to the time I go to bed. It hurts to just move my head.

I also hear a strange noise in the back of my neck every now and then. It sounds like grease when you are frying an egg or something, a bubbling sound. Everybtime I bring this up to my doctor he goes around it and talks about something else.

I have no where else to turn, I am at the end of my rope. What do I do or where can I go to try to get to the bottom of this? I can't do much with my children or family due to these headaches. I am even finding it hard to work now lately. PLEASE HELP ME!!!!!!

Yolanda,

Answer:

Hi Yolanda,

I am glad that you had the full work up for your headaches. A severe head injury such as you are describing could indeed cause post traumatic headache. Clearly you had a head concussion but what could have made it worse would be a past history of head injuries or even minor car accidents BEFORE the injury with the bat.

Here is a link to a headache specialist in New Mexico.

I know you have tried practically every drug known to man, but I wonder if you have ever had IV infusions to treat this pain. In a case such as yours, with 12 years of daily headache, oral medication will only be partially successful. Please talk to the doctor about setting up IV infusions for you. We generally start with 2-3 days of IV's (one per day) on an outpatient basis. The patient has 1.0 gms, of methyprednolisone which is a gentler steroid than prednisone. Solumedrol could also be used. I also put 2.0gms of magnesium in...then the patient may be on prednisone for about 3 weeks with Frova 2.5 daily for the first 5 days. Frova is a long acting triptan used for migraine as many of the headache features are consistent with severe migraine. I know this sounds like alot but it is important to treat headache pain aggressively.

If you have been on Elavil before, I am not sure if you got to the appropriate dose for your headaches. For post traumatic headaches, 50-150mg is the range but it must be tapered slowly, starting at 10mg.

In your case lifestyle changes are vital. Go to bed and get up the same time everyday, no smoking. If you cannot exercise at the present time, hold that until the doctor approves.

As far as the neck is concerned, it may be a combination of arthritis with neck spasming. The majority of headache patients do have headaches AND neck pain.

Finally, if you get no relief with out patient treatment, consider inpatient. There are several headache centers in the United States that do just that, admit for headache treatment. If there are none in New Mexico then you have to work with your insurance company to allow treatment somewhere as services are not available to you in your area.

Best of luck!
Mary Kay Betz MS RPA-C

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Daily Headache Over A Year

by Mary
(New Hampshire)

Daily Headache

Daily Headache

My name is Mary, 30 yr old mother of three. In 12/2008 I began having daily almost constant headaches ranging in pain from 1-10. Mainly left sided, from back of head, top side and behind the eye. Can be dull, constant, stabbing, throbbing or all.

I have been on all of typical and non-typical headache and migraine drugs. Right now Naproxen x2, Gabipentin 500mg, amitriptiline 25mg and lexapro 10mg(for other reasons)daily.

When the pain gets unbearable the only thing that makes it bearable is narcodics, vicodin or percocet. I know the risk of rebound headaches but I feel like I am left with no choice. To throw a curve ball in the picture my menstrual period lasted 30 days. That had never happened before this last month. Although I had had a headache all that time, when the bleeding stopped this weekend my headache got even worse. I am due for my next one as soon as that one stopped.

I have seen different doctors. My current Neurologist is the one who has me on my current meds and I keep in close contact with her. I have been told by a dr that it is the nervous intermedious, and is in a cluster of nerves inside the back of my skull that is causing the pain. I also at times can feel effects of the headache in my nose, teeth and ringing in my ear.

I am in search of any new ideas and would LOVE to hear back from you. What are your thought on pain medications. I need to at least be somewhat active in my life. Have you ever heard of any type of assistance for people who work full time but are not able to go to work because of such chronic headaches?

Thank you.
Mary

Answer:

Hi Mary,

I am assuming that since you are seeing a neurologist, an MRI and MRA of the brain were performed. If all was normal, then the Dr. is on the right track. Amitryptiline is a great choice for daily headaches, and I have also found Depakote to be effective.

We do not recommend use of narcotics in our headache center, as you surmised they do indeed lead to analgesic rebound headaches.

Have you tried a short course of steroid (2-3 weeks) to try and break this? If not, at this point if your neurologist is not a headache specialist, I would recommend that you see one. The New England Center for Headache is a well known center. If there is no headache center in New Hampshire you can petition your insurance company to allow out of state treatment.

Also, have you tried botox for headaches? I am seeing about a 75% response rate and do several a week at this point.

I regularly sign Family Leave Act paperwork for chronic headaches. Ask your doctor to do this for you so you can take time off without losing your job. The paperwork comes from your employer.

Good luck!
Mary Kay Betz MS RPA-C

COMMENTS:

Hi,
This is my first time posting on the web for help. I am 50 yr. old male that has been getting severe headache in the left temporal area extending behind the left eye and ear area. It starts every night around 7-9:30 pm and last anywhere between 1-4 hrs. I do not have insurance but have been to the local VA center for treatment and was given Topiramate 25mg. at increasing doses and ASA 325/Butalbital 50/Caff40mg twice a day as needed. None of htese meds have helped or relieved the pain. I was given a steroidal shot on 1 occasion the did stop the headache for 4 days, but it returned on the 5th day. The did order an MRI of the head, but would not give me the results. It seems that the intensity of my headaches are getting worse and last night during the head ache I took my vitals with B/P 156/96 and pulse at 56. My normal B/P is 108/60 and pulse at 72. I am close to the end as I feel there is no hope for relief and can not afford the doctor bills and testing bills. Any information or advise would be much appreciated.

Answer:

Hi,
Based on what you have said, I would guess the MRI is normal. A headache that occurs at the same time everyday usually has components of cluster headache. These are stabbing unilateral headaches that cause the eye to turn red and the nose to run. Generally they last less than 180 minutes. They do respond to steroid, but you have to be on prednisone for several weeks. These are not migraines and the meds they gave you are for migraine.

Verapamil may also help. This is a calcium channel blocker used for hypertension. It is taken once or twice a day for several weeks.

If you took your blood pressure during a headache it will be elevated, so don't worry too much about that.

If you have not seen a neurologist at the VA, please get to one who can help you sort it out. Ask them about cluster headaches.

Good luck
Mary Kay


Mary Kay,

Thank you for your ideas. I have not had an MRA. I have had an MRI and CT with and with out contrast. Is an MRA something I should talk to my Dr about? Also, I just barely contacted the NE Cener for Headache. The Dr there said that I am working with top drs already and he couldn't help me any more than who I currently have. Would you be able to describe a rebound headache? My headaches are often daily but are mainly one sided and often stabbing and can be pulsating when bad. I get a little sharp stabbing pain on the right off and on.

Thank you again!
Mary

Answer

Hi Mary,

You can read more about analgesic rebound headaches here.

I am glad you are working with good docs. It still sounds like alot of the stabbing pain is spasmotic. Talk to your doctor about the neck influencing the head pain.

Good luck..
Mary Kay

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Headaches Every Day

by Diana
(Greece, Athens)

I have headaches every single day and feel like vomiting after i eat and am only 16

My question is why do i feel like this? I have had headaches for the past 3/4 years and i am dying to find a solution.
I feel like vomiting after i eat;i feel dizzy and i take pain killers it only works for a while and i get moody most of the times. I have headaches more then once everyday and its on and off. I usually have headaches when am hungry. It goes away for a little while after i eat but it doesn't stay for long. Please i really need your help.

Diana

Answer

Hi Diana,

Often times migraines start when you are in your teens. With nausea, vomiting and dizziness, which is actually migraine vertigo, it sounds like this is what is happening.

Unfortunately pain killers and over the counter medications do not work well for severe headaches. They tend to fuel the headache and eventually cause analgesic rebound headaches.

Fortunately you are young! The younger the brain the easier it is to control headaches. You must make lifestyle changes in order to get this problem solved. I think by now you have figured out that pills alone just doesn't work.

Finally, if you are not seeing a neurologist, you need to see one. Talk to your parents and your doctor. A neurologist is trained to treat this and can put you on special medications for a few months.

Good luck!!

Mary Kay Betz MS RPA-C

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Headaches Everyday

by Dallas
(Houston, TX)

Hey, i'm Dallas (guy) and i just turned 15 this September. I have had headaches for a really long time now, maybe 4 years? My headaches usually start at noon or so, and they are almost always behind the eyes. sometimes i will get really bad ones in school, and will be very physically impaired, i will go to the nurse and lay down and want everything completely dark and free of noise and just lay there in pain.

I probably get headaches behind the eyes 50% of the time and headaches on my temples 40% of the time, and then there's migraines, 10% of the time. My migraines get so bad that, as i stated up there, i want everything dark and quiet.

When i get migraines i try my best to get to sleep before i throw up, as i always do if i have a migraine. they hurt so bad the pain is unbearable.

I get my headaches EVERY DAY, it's horrible. i almost always come home from school and am just a wreck. i have tried eating a nutritious breakfast every morning, and taking allergy pills attempting to get rid of sinus headaches possibly. when they get bad, i take ibuprofen. it helps but the headache comes back after it wears off. my headaches are extremely annoying too, like when i wake up with them and they throb.

I have had an MRI, with no results, and drink a lot of water and eat nutritionally. MY life is a living hell with these, and on top of this i have to live with osteoarthritis at this age. Can you please help me?

Dallas

Answer:

Hi Dallas,

With headaches everyday, it sounds like you are moving into chronic daily headache if you are not there already. I know you think that the "migraines" are just the really bad ones, but even migraine can be mild or moderate. I suspect that most of your headaches are migraines and have been under treated.

Migraines can be retro-orbital (behind the eyes), peri-orbital (around them) or unilateral which is on one side only. When a patient tells me that rest in a quiet dark room helps and they want to lie down without moving the head, I know it is a migraine.

I am glad that someone ordered an MRI for you, but a little surprised no one has treated these headaches.

First of all stop all use of over the counter medications like ibuprofen, tylenol, advil, aleve and sinus meds. They fuel the headache and cause analgesic rebound headaches. Your headaches may actually get worse for a few weeks until the brain settles down. Another option is to talk to your doctor and get a medrol dose pak which is a low dose steroid pak for one week. This will break the cycle of the migraine and allow you to stop the OTC meds.

There is no reason as to why you should not have a triptan such as Maxalt or Imitrex for your migraines. Most of my teens do quite well with this and with lifestyle changes, in addition to Migralief, which are vitamins that can prevent migraines. I mention all this as at your age your brain is still growing and tends to do well with alternative therapies.

The neck needs to be addressed if you have arthritis there.

At this point, you might want to talk to your parents about seeing a headache specialist. Most pediatricians, while great at childhood diseases, are not well versed in headache management. Here is a list of board certified
headache specialists listed by state.

Good luck!

Mary Kay Betz MS RPA-C

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headaches everyday

by amber
(modesto,ca)

I'm only 17 and I have headaches everyday. Is there something to do to make them go away? Is it related to stress?

Amber

Answer:

Hi Amber,

Headaches in teens are usually related to stressors such as school, peer pressures or problems at home. It is important that you look at your lifestyle and see how lifestyle changes could help with your headaches.

Having said that..if you have not seen your doctor you should. Talk to your parents about seeing a neurologist who would be able to help you treat your headaches. It is not normal to have a headache everyday no matter what age.

If this is a new onset of headache (within the last few weeks) it is very important that you see a doctor soon. He or she may want to order an MRI or CT of the brain (very quick study!) and then can treat your headaches properly.

Good luck!
Mary Kay Betz MS RPA-C

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