It's not a tumor, but this headache is going to kill me anyway.

July 2, 2012 7:28 PM

I have had an insanely painful headache, possibly caused by a pulled muscle in my neck, for over week and nothing I have tried has helped. I have seen my doctor and his diagnosis/suggestions haven't really led me anywhere. Help me come up with more things to try before I go crazy.

The Saturday before last I experienced intense pain in the back of the left side of my neck, where the spine meets the head. I couldn't turn my head at all and basically stayed horizontal. Later in the day I developed the worst headache of my life, all focused behind my left eye and above my left eyebrow. The kind that makes me double over in pain and scream. Since then I've been out of work because basically all I do is sit around with my eyes scrunched in pain. The neck pain is still there, but has lessened a miniscule amount since Monday.

I went to the doctor a few days ago and he said that due to the neck pain that occurred first he thinks I pulled a muscle in my neck from stress which is causing strain on my face muscles. Awesome. His suggestions were to avoid stressful situations, do some gentle neck stretches (he demonstrated how), and ice the tender part of my neck. I've been doing that but it's not freaking helping! I've been on leave for the whole time in the most stress-free situation possible (no 8 hours in front of a computer, no eye strain staring at a monitor, no crazy clients yelling at me, etc), yet I am constantly doubling over in pain.

Meanwhile I've been scouring the internet and Ask Mefi for other ideas. I have tried all of the following, none of which have made one dent:
-800 mg of ibuprofen every few hours
-1500 mg of tylenol (just once because I am scared of tylenol)
-adjusting my caffeine intake both up and down
-continuing to drink my usual 48-60 oz of water per day
-staying in dark quiet rooms
-heating pads on the neck/head
-smoking cigarettes (I am NOT a smoker but I am getting desperate and will basically try anything that has some sort of numbing effect)
-drinking or not drinking alcohol
-checking my blood pressure (staying around 110/70 which is my normal level)
-trying to eat regularly, focusing on protein (opening my mouth strains my face which makes the pain worse, though)
-trying to sleep a lot, with and without the help of sleep aids
-worth noting: I had an eye exam two months ago and my vision is fine

So. Tomorrow I am going to try acupuncture. What else should I consider trying? Anything special to try for a pulled muscle that is taking forever to heal? For example, would shiatsu massage possibly help or make things worse? And finally, at what point should I go back to the doctor?

posted by joan_holloway to health & fitness (27 answers total)

I would go back to do the doctor and ask for an MRI. There are lots of very important things where the base of your skull meets your spine. You really don't want to mess around back there.

I have something called a Chiari Malformation that affects that same area, so I get a lot of neck pain right at the base of my head. Something that helps me is to lie flat on the floor (carpet is ideal...beds are too squishy) with an icepack under my neck. Head only supported just enough by a thin pillow to keep the neck straight. I don't know if that will do anything for you, but you've tried everything else, so why not.

But I would definitely ask for an MRI of the head and cervical spine just to make sure there's nothing more sinister going on.
posted by phunniemee at 7:35 PM on July 2, 2012 [2 favorites]

Yeah, I'd go back to the doctor ASAP. Sooner, actually. Intense pain that hasn't lessened in severity for over a week simply doesn't sound like a pulled muscle. IANAD and all that.
posted by cooker girl at 7:37 PM on July 2, 2012 [7 favorites]

My suggestion is probably not a cure all, but it won't hurt either:
Epson salt bath? Magnesium helps relax muscles (among numerous other processes in the body) and magnesium deficiency is very prevalent in the United States. 2-3 cups full of epson salt in a hot tub for at least 12 minutes before bed time.

Good luck!
posted by Neekee at 7:38 PM on July 2, 2012

This happened to me last week; it took a couple days of Rx painkiller (Ultram) and a muscle relaxant (Flexeril) to finally fix it. But I would really urge you to go back to your doctor to rule anything more serious out.

As for being scared of Tylenol (acetaminophen): don't be too blithe about taking lots of ibuprofen, either. Sustained high doses of it can cause bleeding (including stomach bleeds). Not to freak you out, but just to suggest you not exceed the daily dose on that score, either.
posted by scody at 7:39 PM on July 2, 2012 [2 favorites]

Chiropractor? Honestly I'd rather report the persistent pain to a doctor.
posted by ceribus peribus at 7:50 PM on July 2, 2012 [2 favorites]

Get a massage from a very experienced, highly recommended masseuse. get a recommendation for someone who listens well and make sure you describe the injury. I used to get wicked brain splitting headaches from neck problems and the massages always helped.
posted by gt2 at 7:57 PM on July 2, 2012 [1 favorite]

While it's probably just stress, etc....

I'd go get a second opinion. "worst headache in my whole life" is something someone who is having an aneurysm says (I've known 3 people who that was their symptoms and exact words. )

I'd push your doctor a little more. My friend who had an aneurism start to leak had to go to the ER 3 times before she was treated seriously.
posted by bottlebrushtree at 8:22 PM on July 2, 2012 [1 favorite]

I *had* *this* same headache (as per your symptoms) a few months ago. It seems that I strain/pull my trapezius muscle, there's a nerve that goes through that gets irritated, and this nerve reaches from the base of the head, up over the skull and then behind the eye. I do this by swimming or from sitting 'incorrectly' when I'm stressed (the whole chin-forward posture).

Anyway, I realize now that this has been going on with me for a while, but the headache I speak would not quit, just kept going for three days, and was unresponsive to all OTC and migraine stuff (Midrin and sumatriptan). So I went in to the doctor, who explained her theory about the muscle sequence to me. I was prescribed muscle relaxants (cyclobenzaprine) and given a shot Tramadol right on the spot. The Tramadol was a relief and then when I took the cyclobenzaprine upon arriving home, I slept for four hours and woke up all better. So I would suggest asking for those two things to get the short term, immediate relief that you need. I also second the suggestion to request more investigation, like an MRI, etc. I have actually had several research MRIs of my head, so I am relatively sure I don't have a tumor, but had the pain not gone away, I would be requesting scans and more explanation.

However, I don't know what to tell you for long term, because it seems like this will happen again, and if you're like me, muscle relaxants are not a long term solution if one wants to hold a job. Now that I am a bit more aware of this, I have been trying to keep better posture and do some of the exercises recommended for 'chin-forward', but this has not solved whatever I am doing wrong swimming nor have I completely avoided the stress headaches. I will be watching the thread to see what other folks say.
posted by Tandem Affinity at 8:24 PM on July 2, 2012 [2 favorites]

I tend to get neck pain that causes headaches and I've found that rubbing Tiger Balm on my neck helps quite a bit. It doesn't do a lot for the headache though, unfortunately.
posted by dreamingviolet at 8:28 PM on July 2, 2012

Tandem Affinity has got it. Sounds like you need some muscle relaxants and some physical therapy to me. Something's weak, or something's out of alignment, or both. And like others have pointed out, who really knows? It could be something much worse. So far your doctor hasn't helped at all. Are they normally any good? The time to deal with this is now.
posted by facetious at 8:30 PM on July 2, 2012

Jesus Christ go to the ER and don't leave until they figure out what is wrong. If three doctors and a bunch of tests say it's a pulled muscle, then get some real painkillers for the pain, but I would be getting second and third opinions before I'd accept that diagnosis. Oh and go to a big university hospital if you have one near you. Somewhere with lots of specialists. I would seriously go now. The ER probably isn't too crazy right now, but it will be on the 4th.
posted by whoaali at 8:30 PM on July 2, 2012 [1 favorite]

I think you have pinched nerve in your neck/spine and the pain is radiating into your face. My guess is that you need to see an Orthopedic doc who will prescribe a steroid. It will clear up in about two days after the first dose of the steroid. If it is really killing you, go to an ortho as a walk in, pay the fee and have your insurance reimburse you. Hope you feel better soon.
posted by bkeene12 at 8:38 PM on July 2, 2012

Chiropractor?

With severe head and neck pain? I'd think twice.
posted by en forme de poire at 8:50 PM on July 2, 2012 [3 favorites]

I NEVER say this, but: ER. There's a saying in medicine that the headaches you should be concerned about are "first, worst, and cursed" (that is, a headache in someone who's never had one, "the worst headache of my life", and headaches "cursed" with extra non-pain symptoms). Is it PROBABLY non-scary in origin? Sure. But even still, horrible, unrelenting headaches merit a conservative approach.
posted by julthumbscrew at 9:25 PM on July 2, 2012 [4 favorites]

It could be a slipped disc in your back- that's what I have and what you are describing sounds like my former symptoms. For future reference and if that's what it turns out to be- I was able to greatly, greatly, lesson the pain through regular exercise, especially yoga.
posted by bearette at 9:44 PM on July 2, 2012

You need to see a doctor who takes you seriously. My recent bout of hell really was a pulled muscle, but I had an X-ray, cat scan and MRI to rule out more nefarious causes. You need to do this! If you can't see a doctor in the next 12 hrs, go to the ER.

If it turns out to truly be a pulled muscle (my pain was exactly where yours is), the only thing that has helped was experimenting with different sleeping positions. I sleep on my left side - counterintuitive - and use one of those neck support pillows. I hug another pillow to keep my shoulders aligned. Overnight I was pain free.

Insist on tests, you don't want to be wasting time with acupuncture if it's a slipped disk or an aneurysm.
posted by desjardins at 10:48 PM on July 2, 2012

IANAD and I do agree with the people who say you should get (more) medical advice, and also that massage could help. But, I had this exact problem a few weeks ago --- here's what fixed it.

(This is easy and you can do it right now.)

Sit in an ordinary kitchen-type chair, as far to the front edge of the chair as you comfortably can. Spread your legs wide and slowly bend from the waist so that your head ends up below your knees and you are looking at the chairback or the wall behind the chair. Your arms should be resting on the floor, or held crossed in the air between your head and the floor, helping gravity pull your head gently down and forward. Don't stretch too much, don't hurt yourself. Gently hold that position for about a minute. It shouldn't hurt. If it hurts you should probably stop.

I did this after having a headache for about three days straight, and the pain totally disappeared.

I used to have a TON of neck pain and base-of-head pain related to working all the time crunched up on a small laptop. I was in some degree of pain almost half the time, and needed to get regular massages just to keep it in check. Since my physical therapist taught me this stretch, I haven't had a single headache.

Good luck!
posted by Susan PG at 11:11 PM on July 2, 2012

BTW longer-term, for you and anyone else with constant pain, I recommend the Alexander Technique. When I say physical therapist above, I'm really talking about my AT instructor.

I started AT after being in lots of pain for a year or so, out of sheer desperation. It sounded kind of woo to me, and I expected it not to work. It still *feels* woo, but I've been totally pain-free since I started instruction a few weeks ago. It could be placebo effect, I guess, but if so, that's fine with me :-)
posted by Susan PG at 11:19 PM on July 2, 2012

Neurologist or er.
posted by yarly at 4:32 AM on July 3, 2012

My cousin had a similar thing and it turned out that she had a small tear in her spinal column and spinal fluid was leaking into her brain (OW!) They injected some medical fix-a-flat and the pain stopped.

This happened at the base of her neck, so yeah, that might be a thing to check.
posted by Ruthless Bunny at 6:26 AM on July 3, 2012 [1 favorite]

Thanks, everyone, for the answers so far. Fortunately I survived the night without my brain exploding!

Right now I tend to believe my doctor's diagnosis-- my husband and I can definitely feel some muscle in my neck area that feels swollen/knotted/unhappy. I also noticed this morning that doing anything that puts strain on my neck makes my head feel worse. I have no idea how I injured it, but I do carry a lot of tension in my upper body from being high-strung and having terrible posture at work. I slept with a neck pillow under my neck last night and woke up feeling better-ish.

My doctor offered a trigger point injection in the neck area so I might try that. He also offered muscle relaxants but I would rather not resort to that yet because I don't want to be a total zombie. I'm open to additional suggestions and definitely will seek medical attention if I develop any new symptoms.
posted by joan_holloway at 9:25 AM on July 3, 2012

Just as a data point (warning, MedicalAnecdoteFilter!) I had a horrible muscle spasm in my neck once that was so bad I couldn't turn my head without blinding pain. I went to the ER and they gave me a shot of morphine which basically did nothing to touch the pain and made me vaguely itchy to boot. But they then gave me a Flexeril, and that fixed the entire thing quickly and permanently. I had a prescription for a whole bottle and I ended up letting it expire without ever needing another one (touch wood). Anyway my point is that if you get a scrip for a muscle relaxant it may be a totally short term or even one shot thing.
posted by en forme de poire at 9:39 AM on July 3, 2012

My doctor offered a trigger point injection in the neck area so I might try that. He also offered muscle relaxants but I would rather not resort to that yet because I don't want to be a total zombie.

You've been suffering for over a week. A muscle relaxant could very well clear it it up in a day or two. Is being loopy for 24-48 hours worse than continuing to be in pain for days or weeks longer?
posted by scody at 9:45 AM on July 3, 2012 [4 favorites]

I was going to say exactly what scody said. You will not get a gold star for being tough. You will also not likely become a zombie.

This "I must tough it out" mentality might be contributing to your overall stress level, too.
posted by desjardins at 9:54 AM on July 3, 2012 [1 favorite]

I have migraines triggered by tension headaches caused by tension in my neck and upper back. Cyclobenzaprine (generic Flexeril) taken before bed causes me to zombie through one day, and then the headache is GONE.

If I don't take the muscle relaxant, I zombie through several days, up to 2 weeks, as the headache sticks around.

The math is simple to me (and the earlier I take the meds before I sleep, the less of a zombie I am the next day).
posted by telophase at 1:06 PM on July 3, 2012

Neck brace? It'd help your neck muscles relax for a while. You can get one without a prescription from a medical supply store.

Also, docs who really know trigger points are rare. But massage therapists who do, less so. If you think you have a trigger point, get thee to a massage therapist, and/or have hubby work on it. Pain behind the eyes tends to be associated with suboccipital muscle trigger points, so that's a good place to start.
posted by parrot_person at 3:30 PM on July 3, 2012

Update time! I got pretty fed up with the whole thing and we drove to an urgent care clinic yesterday afternoon. You guys are right, and I am really not one to play tough guy! Doctor #2 confirmed doctor #1's diagnosis and said there's no evidence of anything more sinister like an aneurysm. He identified the muscle in my neck that is stiff and thinks it is pressing against my occipital nerve which is causing the headaches.

So, he gave me a lidocaine trigger point injection in the neck (WHOA, that was intensely painful) as well as a muscle relaxant (robaxin) and a different anti-inflammatory (diclofenac). It's been about 7 hours since the injection and 4 hours since I took the pills. My damn neck and head still hurt! Argh. The doctor said to give it a few days and if I am still in pain on Thursday that it's time for a MRI to check for other things.

Also, I am now wondering if my lack of relief from the trigger point injection is further proof that I am one of those redheads with a resistance to analgesics. I always joked about that because I hardly ever get numb at the dentist, but geez, this is a terrible time for it to be true.

Please cross your fingers that this headache BS goes away soon!
posted by joan_holloway at 3:53 AM on July 4, 2012