What should I do?

Okay, so I was starting to get better, had more good days than bad. Well for the last 7-8 days the pain in my neck and head have been bad and non stop. I just can't take it anymore. Just when I thought I was getting better, it seems I am worse.

Hi holmsla,

My hear goes out to you with the pain you are suffering right now!!! Yes, I do think you should go for a second opinion if you can.

Please try and stay away from the narcotic meds as they do more harm than good in the long term!! Hang in there!!

take care

Ann

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Co-Moderator of the Migraine/Headache Forum

Thanks for the reply. I guess I was looking for narcotics only because it seems to be the only thing that helps to reduce my pain. I don't take it daily, only when it is too much to handle. Maybe one to two times a week at the most. I don't like taking it too much for obvious reasons. I take Relpax as needed, but they are really expensive so it is not something I can take every day. Of course that only addresses the migraine and not the neck pain.

Well, it's important to realize that even if you could afford daily relpax that you can only take it 2-3 times a week max. You mentioned that you saw a neurosurgeon, which is better than just seeing your primary physician, but it's not the same as seeing a neurologist that specializes in headaches.

I really know what you mean about not being able to handle the pain some days. But there are a lot of things that can solve that problem (e.g. anti-inflammatory medications, triptans, ergotamines, anti-psychotics, and ESPECIALLY an effective daily preventative medication(s)) before you and your neurologists should even consider starting narcotics pain treatment.

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DX: NDPH, Recovered CRPS
RX: Lamictal, Abilify, Verapamil, Provigil, Clonazepam, Ambien CR, Rozerem, Emsam, Namenda
PRN: Haloperidol, Zyprexa, Lodine, Zofran, Oxycodone

I have already tried just about all the above, Preventative (Topamax), anti-inflammatory (Ibuprophen, Naproxen...ect), Triptans (Imitrex & Relpax) & antidepressant (Cymbalta) use to treat nerve pain. I also go to the chiropractor, now only once a month as opposed to every week. I even tried massage therapy. I saw a neurologist that specialized in migraines and he gave me an occipital nerve block and referred me to physical therapy, which I tried as well to no avail. He could no longer help me as he felt that my pain is a result of my neck injury. He then referred me to an anethesiologist. The anethesiologist tried epidural cortisone injections (two series), a medial branch block, and a cervical rhizotmy (burned my nerve endings). None of which worked. I finally decided it was time to see a neurosurgeon that specialized in the spine. He basically told me to get off the meds, exercise and forget it all happened. He said that even if I needed surgery he would not do it because I am too young and would need surgery every 10 years or so. He said I had spondylosis with a tiny bone spur, but that would not be what is causing my pain.

Sorry, I wasn't aware how complicated your case is!  I didn't mean to speak like you were a drug seeker, I just wanted to steer you away from that route if you had other options still.

I don't know a lot about neck and upper spinal injuries.  However, I think that a respectable headache specialist wouldn't give up so easily.  There are many many different types of preventative medication.  Even if you do have secondary headaches (caused by some other injury, that is), many people don't respond to the three prescripton strength medications that you've listed. 

For example, I responded moderately well to zonegran, but not to topamax, even though they're both antiseizure meds.  Then you also have bipolar type drugs like divalproex (aka valproic acid, depakote), lamictal, and lithium.  Antidepressants and antiinflammatory medications can also be used as preventatives, beyond cymbalta and ibuprophen, naproxen.  There are tricyclic antidepressants like neurontin and elavil; SSRIs like lexapro, zoloft, paxil, and prozac; SNRIs like effexor and cymbalta; MAOis (quite strong) like nardil, parnate, and emsam; and others like Wellbutrin, Zyban, and others.  As for antiinflammatory medications, ibuprofen and naproxen are fairly weak and are rarely advised to take daily.  Some strong ones that are sometimes taken daily are diclofenac, etodolac (lodine), ketorolac, indocin, and relafen.  There are a few other strange ones like metergine, mexilitine (oral lidocaine) and various herbal remedies.

Also there are a variety of other triptans: Maxalt, Amerge, Zomig, Axert and Frova.  I found that some work better than others.  Many of them didn't work at all and a few helped a bunch more for me.  And as for other abortives there are strong inflammatory ones like todadol, strong antipsychotics like zyprexa, haldo, droperidol.  And things like DHE, lidocaine nasal spray, etc.  You can try oral steroid tapers, since you said that worked.  Plus Botox injections, nerve stimulators, etc.

Anyway, if you know all this, I'm sorry to make you waste your time reading.  But I just wanted to get across the point that there are nearly innumerable types of medication and other treatments (and these are only the ones that I've tried); most likely you haven't tried many of them.  Don't let any of your doctors give up on you.