Severe Headaches

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gngr78us
New Member


Date Joined Sep 2009
Total Posts : 2
   Posted 9/9/2009 9:21 AM (GMT -7)   
Hello everyone, I happened to stumble across this site and I am looking for some adivice. I was in a car accident(rear ended 60mph) Nov 08. I have been experiencing excuritating headaches since that day. Went to regular GP, he gave me muscles relaxers, tramadoyl and sent me to Chiro. If I take the muscle relaxers morning and night, the headaches arent so bad, more less tightness where my head meets my neck behind my ears(occipital area). Chiro tried for 4 months (tens unit,physical therapy, traction and manipulation)to fix issue and that didn work. The traction was the worse, 6 hours after it, I was then miserable for 3 days and he wouldnt touch me. He sent me to Pain Management/Physical Therapy(hands on)(3 months). PM/PT did a MRI on my neck and I have a small disc protrusion, I got shots in my neck(facet) since they thought that was causing my headaches. 3 weeks after, I still have these headaches. The flexeril still takes the headaches away if i take meds almost exact same time. If I happen to take it even two hours late, the next three days are miserable and all I want to do is lay down. If I skip a dose, I can feel it coming on and its then to late to stop it from coming a major pain. The tramadol I try not to take because I dont feel it does anything other than making me sleepy. Nothing as far as sounds or lights make it worse. Heat nor cold seems to make it better or worse. The most that makes it worse (with meds) is coughing, bending over to put on shoes, or getting up off the couch/bed. This is affecting my everyday life and want it to go away.

korbnep
Regular Member


Date Joined May 2007
Total Posts : 327
   Posted 9/10/2009 8:12 AM (GMT -7)   
Hello,

With back injuries there is a wide range in severity and a correspondingly sizable array of different treatments. Ideally, as much information is gather about the injury as possible and the proper course of treatment (from short-term pain relief to surgery) is assessed, usually starting more conservatively to avoid unnecessarily invasive (and expensive) treatments or procedures.

It seems like your GP approached the problem most conservatively, trying to treat your pain without directly addressing the physical trauma. Most disc displacement problems heal on their own within 6-12 weeks, so a more aggressive approach would most likely have not been appropriate (though I don't know why you had to go through three doctors before imaging studies were ordered).

Next you went to a chiropractor and didn't have much luck. I'll admit that I'm somewhat prejudiced against chiropractics in general--a large portion of practitioners rely on rather blunt techniques derived from pseudoscientific principles (not everything can be fixed by spinal manipulation!)--but I do believe that a good chiropractor (particularly with more modern training) can be very helpful. In your case, you report that he failed to resolve the issue and frequently made the pain worse. Again I wonder why you had not yet had an MRI study ordered. Trying to fix your back without actually knowing what was wrong with it, the chiropractor was probably as likely to cause a problem as to fix one.

But the important part is that you did find out that the likely culprit is a disc protrusion. Unfortunately the (cortisone?) injections didn't help but seeing a PT who does PM is a good step. I'm unclear as to whether you have tried PT for 3 months or 3 weeks. If it has been as long as three months and you haven't found relief, try talking to your therapist about your lack of progress and ask what sort of timetable they're looking at. PTs are trained to be very goal-oriented so this sort of discussion will hopefully be fruitful. If you and/or your PT don't feel like you're making progress you discuss a referral to an orthopedic specialist (given the nature of their work many PTs have relationships with good orthopedists).

An orthopedist will have the best resources at his or her disposal to find a solution to your problem. You might be advised to have corrective surgery. While it hopefully won't come to that, if conservative treatments have failed it may end up being a smart choice (especially considering how much you very understandably want it to just go away).

I wish you the best of luck. Having a painful back injury is a terrible thing but knowing the specific source of your headaches gives you greatly increased odds of finding a solution. Keep us posted on your progress.

Ben
DX: NDPH, Recovered(?) CRPS
RX: Lamictal, Namenda, Wellbutrin XL, Oxycodone, Oxycontin, Concerta (Methylphenidate), Clonazepam, Rozerem, Magnesium (1200 mg/d), Riboflavin (400 mg/d).

PRN: Ketamine nasal spray, Toradol IM, Celebrex, Haloperidol, Lodine, Zofran, Phenergan, Ambien CR
rarely: Migranal, Thorazine, DHE IM, Droperidol IM, Reglan, Provigil, triptans (Imitrex, Maxalt, Relpax, Zomig, Axert, Amerge)

I can be contacted personally via email at korbnep:healingwell@gmail.com.


gngr78us
New Member


Date Joined Sep 2009
Total Posts : 2
   Posted 9/11/2009 8:43 AM (GMT -7)   
BEN,
After 3 months the PM/PT decided not to continue with PT because it wasnt doing any good. Its my neck where the disk problem is but the shots have cured the sharp pain, just didnt work for my headaches. Last Wednesday, I seen the PM again and he gave me shots in my neck and shoulder muscles which didn seem to do anything either, for my headaches. I dont seem him for a month, but I called his office to see if I/we can do something else.
Jen

korbnep
Regular Member


Date Joined May 2007
Total Posts : 327
   Posted 9/11/2009 2:37 PM (GMT -7)   
Jen,
 
Well, a pain management specialist might not be the best person for the job in this case. I've been to a few pain specialists and they've honestly been great but I don't think that they provide the kind of treatment that you probably need right now. In the case of physical trauma a pain specialist typically, well, works to reign in chronic pain that comes from an injury that a patient is either recovering from or cannot recover from. In short they treat the symptoms but not the cause (generally).
 
It's good that the sharp pain has subsided but the abscence of pain proximal to your injury doesn't necessarily mean that the injury is no longer causing problems--I'm sure you know this and I don't mean to sound patronizing but it's an important point. Your protruding disc could be pinching or damaging a nerve or blood vessel; the shift in your spinal column may have changed the pressure of your cerebral spinal fluid; the accompanying muscle tension may be triggering headaches in a variety of ways--these are just purely speculative potential sources of your headaches. Your headaches might not even have any direct connection to your displaced disc (an MRI can only show some of the very many potential headache sources).
 
The point that I'm driving at is that, if your back injury is under control then your main problem is headache. With that in mind it may be wise to see someone with more experience in treating headaches. In most cases of chronic headpain I recommend seeing a headache specialist--they've simply the best equipped to help you. However, in this case a general neurologist with experience in treating headaches may do just fine (particularly considering how long you sometimes have to wait to see a headache specialist).
 
In any case I suggest that you discuss your prognosis with your PM. Ask him whether he thinks that he can treat the headaches. A good doctor will admit when he is not the best person to help you.
 
If you decide to see a headache specialist and need help finding one be sure to let us know. Keep us posted and best of luck!
 
Ben
DX: NDPH, Recovered(?) CRPS
RX: Lamictal, Namenda, Wellbutrin XL, Oxycodone, Oxycontin, Concerta (Methylphenidate), Clonazepam, Rozerem, Magnesium (1200 mg/d), Riboflavin (400 mg/d).

PRN: Ketamine nasal spray, Toradol IM, Celebrex, Haloperidol, Lodine, Zofran, Phenergan, Ambien CR
rarely: Migranal, Thorazine, DHE IM, Droperidol IM, Reglan, Provigil, triptans (Imitrex, Maxalt, Relpax, Zomig, Axert, Amerge)

I can be contacted personally via email at korbnep:healingwell@gmail.com.

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