Have you ever had trauma to your neck?? Car accident or injury??
I was in a car accident 9 years ago. 3 years after my accident I started having headaches every day. When they got bad enough I would have a migraine. I went through 3 years of diagnosis until I found out it is something called cervicogenic headaches. It kind of feels like a tension headache. BUT if it is left untreated it will turn into a migraine. I have gone through physical therapy injections and most medications used to treat headaches.
If it is a pinched nerve in your shoulder than the inflammation needs to be reduced. Some kind of short term anti-inflammatory, muscle relaxer and maybe some moist heat.
I agree I wouldn’t take the topamax. I am surprised they even prescribed that. I would take the flexeril at night. Maybe a ¼ or half during the day if you can stay awake. Just something to keep the shoulder relaxed. Also try not to stress your shoulder. Things like heavy purses and bags can cause that problem too. Then it becomes harder to fix.
I had a pinched nerve in my back and they did a trigger point injection. (cortisone shot) It worked very well.
If you have pain in the back of the neck that is causing headaches then that is a different story. Because of stress and location it is a lot harder to get rid of the pain. Right now I am prescribed strong narcotics so I can function every day and get out of bed.
Before you let someone work on the upper spine make sure they are well trained in that area. My problems were up at C1 & C2. I was told by my physical therapist that if anyone ever touched that area they needed to be certified to do it as not to cause more injury.
Best of luck to both of you.
Those were just some of my ideas.