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Old 08-22-2009, 03:39 PM   #1
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Exclamation Cervicogenic Headaches (Please help me!!!)

Is there anyone out there who has any experience with this diagnosis, treatments, etc??? I've done a lot of searching on the web and have yet to come up with a clear course of treatment.

My symptoms are as follows. 13 years of tension headaches that have gradually gotten worse. I believe they stem from a playground head injury when I was six, in which I fell off the monkeybars and landed on my head/neck. Started out as classic tension headaches 13 years ago, but also manifested as brief, stabbing, brain-freeze-type headaches as well. After visiting a chiropractor four years ago, pain got markedly worse, classic tension headaches got more frequent, and brain-freezes got more frequent/intense. For the last 1.5 years I've had a knot in my right shoulder that does not go away. For the last 2 months I've had 6 utterly agonizing/incapacitating attacks of pain radiating from right shoulder up through neck, scalp, and right forehead. Left side is not affected as far as pain goes, but left shoulder is pulled up much higher than right. All seems very related to posture/activity/barometric pressure. Ended up in ER once, as pain lasts from 6-12 hours without relief, and would have gone every time if it hadn't been for the knowledge that I couldn't take the wait. The pain drives me nearly insane, and I initially thought cluster headaches, but there are a number of factors that disqualify that diagnosis. MRI's and X-rays show nothing abnormal, other than very slight narrowing between C-4 and C-5. Pain management doc dx'ed with cervicogenic headaches and noted the presence of numerous trigger points. Have had 2 rounds of trigger point injections within 1 week, but they do not seem to help very much. Physical therapy triggered another attack, so I'd like to get the trigger points resolved before doing any more. Doc also placed me on muscle relaxers, ultram for pain, relpax for pain (doesn't help), and an anti-depressant (per migraine model). He seems to think there is a migraine component to all this, though I think he's mistaken. (No aura, light/sound sensitivity, lack of responsiveness to migraine abortives, etc.)

Since the TPI's did not help, what is the next step? Nerve blocks? Botox? Have the TPI's really been implemented correctly, as most protocols seem to call for multiple rounds within just 2-3 days of each other? Should there be some diagnostics done that have not been, as doc diagnosed based solely on symptoms and presence of trigger points? I don't really trust my doc (a pain management specialist) at this point, because he isn't following the basic diagnostic route laid out by the articles I've read (NIH and American Journal of Osteopathy or something like that).

Please help me. The pain is incredible. I scream a lot, and I'm not a screaming type of guy. Feels like neck/shoulder muscles are going to tear or detach from my skull. At this point, I'd rather die than go through another one of these ba****ds, but I see very little in the way of a positive prognosis. I don't want to become addicted to pain meds, nor do I want to spend 2 years jumping through hoops with little to show for it. I want to nuke the snot out of this thing, make sure it's good and dead, and get back to my fairly active life, which has been brought to a screeching halt by these attacks. Sorry if I'm garbled, pain meds and all that.

 
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Old 08-23-2009, 08:36 AM   #2
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Re: Cervicogenic Headaches (Please help me!!!)

Hi Stillkickin, I have 2 bulging disc at C5-C6. It took me years to find out what is wrong. I could not do physical therapy, just made it hurt worse. Stay away from Chiropractor's, they only make things worse, unless you find one that does only massage of the muscles, but that is only a feel good, not a fix. My pain management started me on trigger points injections with epidurals. I had 4 epi's in a year and a half. The first three helped, but only for about 3 months at a time, the fourth one seems to have helped a lot, it has been since February since then and I am doing pretty good, I am still getting trigger points , but my headaches are only minimal pain. By the way, mine are all on the right side. I take flexeril and cymbalta at bed time, and I only take Ibuprofen 800mg for pain. I refuse to take anything addictive. If I were you, I would ask your doc about the epidurals, they can bring great relief, and they are not bad to get. Some people take anesthesia for them, I took nothing and it did not hurt me. Just a little pressure. They numb the area first. I hope this is of some help, I know the headaches can be terrible.

Sunny

 
Old 08-23-2009, 10:46 PM   #3
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Re: Cervicogenic Headaches (Please help me!!!)

Hello,

Please read my #1 post; I recommend a book called "How to Heal A Headache". It will help you understand your migraines. Your doctor is actually right surprisingly! The reason I say that is because I had been in the hospital, Urgent Care, ER almost 100 X's in this last year and not one doctor could diagnos me. I had severe vertigo and other strange symptoms that were all from migraines. Most people including doctors don't know about the many different symptoms migraines create. Please read my post it should help you.

Last edited by leeshy215; 08-23-2009 at 10:50 PM.

 
Old 08-26-2009, 09:07 PM   #4
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Re: Cervicogenic Headaches (Please help me!!!)

Hi, I just read your post and have a few questions. Could you possibly have overstretched or torn ligaments in your neck when you fell? I'm not suggesting that could be your whole problem, but possibly a contributing factor. Ligaments don't always heal 100 percent and when they aren't properly supporting the bones (including the spine), people can have problems. In your MRIs where you say it shows a slight narrowing between C4 and C5, do you mean due to herniations or just a narrowing of the spinal canal? Do you actually have the MRI films? If so, when you look at them, is there anywhere that looks like the CSF is not flowing properly around your spinal cord? How about the brainstem? Without getting into my whole history right now (I have to get to bed), my neurologist believes that my long-term head issues are related to blockage of CSF around my spinal cord due to herniations and bone spurs. I am greatly affected by positional and barometric changes. The last time I let a chiropractor adjust my neck, I ended up on my couch for several days straight in a sitting up position leaning against the back of it. The pressure in my head was unbearable. I am currently appealing my insurance company to get artificial disc replacement of two discs (he will also remove the bone spurs) - but, I am still doing my own research. I feel like I have spent far more hours doing medical research than many doctors. It seems you've done the same.

 
Old 08-27-2009, 08:54 AM   #5
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Re: Cervicogenic Headaches (Please help me!!!)

Quote:
Originally Posted by catelynnw3 View Post
Hi, I just read your post and have a few questions. Could you possibly have overstretched or torn ligaments in your neck when you fell? I'm not suggesting that could be your whole problem, but possibly a contributing factor. Ligaments don't always heal 100 percent and when they aren't properly supporting the bones (including the spine), people can have problems. In your MRIs where you say it shows a slight narrowing between C4 and C5, do you mean due to herniations or just a narrowing of the spinal canal? Do you actually have the MRI films? If so, when you look at them, is there anywhere that looks like the CSF is not flowing properly around your spinal cord? How about the brainstem? Without getting into my whole history right now (I have to get to bed), my neurologist believes that my long-term head issues are related to blockage of CSF around my spinal cord due to herniations and bone spurs. I am greatly affected by positional and barometric changes. The last time I let a chiropractor adjust my neck, I ended up on my couch for several days straight in a sitting up position leaning against the back of it. The pressure in my head was unbearable. I am currently appealing my insurance company to get artificial disc replacement of two discs (he will also remove the bone spurs) - but, I am still doing my own research. I feel like I have spent far more hours doing medical research than many doctors. It seems you've done the same.

I very well could have messed up my tendons. For the last couple of years, I've been able to pop my neck to relieve some of the pressure. I just push on the right side of my head, bending my neck to the left, and there are usually 2-4 loud pops. The gap between the vertebrae is a compression type of gap. I've not had any 3-D imaging done yet, but fortunately, I was able to find another (much better) doctor who has ordered MRI/MRA. I think I'll know something more definite after the results come back. Also, the better doc did an occipital nerve block and that has brought a lot of relief for the past 3 days now. Yes, it does seem that there are many doctors who don't put in the research time in order to actually be able to help their patients. Where he and his PA classified my condition as "classic," the new doc said she was puzzled and would have to do some research. I think part of the problem is the different mindsets in physiatry vs. neurology. The good doctor is in neuro. Thanks for the reply, by the way.

 
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