YANMD Is it all in ( or on) my head?

February 3, 2018 9:45 AM

I wake up most mornings grouchy, with dull aches and pains everywhere, most notably in the form of what feels like a knot in my corrugator or orbiculari oculi muscles ( right between the eyebrows and behind the eyes) and in a brain fog that no amount of coffee can shake. Even recent ( very positive) changes in medication leave a lingering depression and inertia that doesn't go away with any amount of sleep. I have a really strong urge to either climb back into bed or stare into space for six hours. Hope?

Possibly pertinent medical history:
- I have cerebral palsy
- I've had a sleep study, but there doesn't seem to be any "there" there. No apnea/other issues.
- I fell onto pavement years ago and, with time, became more and more certain that the fall had broken my nose. I allowed it to heal on its own, though, and now, it's ever so slightly crooked.
- A sinus CT, brain MRI ( both relatively recent) and EEG were unremarkable. I have a nasal polyp and slightly swollen turbinates, but nothing that has prompted recommendation for surgery.
- I DON'T think this is a sinus/mucosal issue. Why?
When taking a muscle relaxer ( aclofen, 20mg) that annoying knot goes away and oh my god, you guys, it feels like I just drank coffee, meditated and got to pet a miniature pony, all at the same time. There's a euphoric, calm wakefulness that spreads over me within minutes. My mood changes, I can think, and do things without feeling like lead, for a few hours.

I thought this may be a cervical nerve issue but I never have any pain or tingling that radiates. I'm also doubting migraines, because in my mind, the pain of a migraine should be more intense than this is, but not ruling them out.

What could this be? No doctor has figured out what to do. Do you, as not-my-doctor, have any novel ideas?

posted by marsbar77 to Health & Fitness (21 answers total)

Response by poster: Er, that's Baclofen!
posted by marsbar77 at 9:46 AM on February 3, 2018

I get this from my allergies. Just a thought.
posted by MexicanYenta at 10:00 AM on February 3, 2018

Have you tried sleeping with your upper body slightly elevated? If it's a congestion issue, this should help.
posted by Scram at 10:16 AM on February 3, 2018

How's your pillow situation? The muscle relaxer test would suggest you've got a lot of neck/head/face tension when you wake up in the morning.
posted by Lyn Never at 10:25 AM on February 3, 2018 [2 favorites]

Response by poster: Not to threadsit, but the pillow situation is, uh, awful, perhaps not coincidentally. I'm a side/fetal position sleeper with an old, deflated down pillow. Recommendations for a replacement would be awesome, though I should mention I never really liked being too high up either.
posted by marsbar77 at 10:37 AM on February 3, 2018

Tension headache?
posted by Seeking Direction at 10:54 AM on February 3, 2018

> I fell onto pavement years ago

How many years ago? You've got a lot of symptoms of post-concussion syndrome, there. (I see symptoms of PCS everywhere; it's my superpower.) I have PCS and got dramatic relief from symptoms for going to a physical therapist for what I thought were unrelated symptoms.
posted by The corpse in the library at 10:59 AM on February 3, 2018 [1 favorite]

Do you/ can you get relief from a leisurely hot bath to let muscles unwind? Meditation and progressive relaxation may also help.
posted by theora55 at 11:40 AM on February 3, 2018

Nthing a good pillow amd matress setup may help with this. Maybe go to the store and try things out tonsee what may be good. Target brand quality pillows need to be replaced every few months, but they're cheap so this may be an option. Especially if it helps with this issue.
posted by Kalmya at 12:07 PM on February 3, 2018 [1 favorite]

Brain fog plus pain behind the eye could be a migraine. I wake up with them sometimes.
posted by mrmurbles at 12:57 PM on February 3, 2018 [1 favorite]

New pillow worth trying. Maybe get two so you can adjust height. Higher and harder if sleeping on your side. If you have allergies to dust or dust mites a down pillow might not be the best choice either. Some pillows come with instructions as to which sleeping positions they are good for, maybe do some research on that.
You're not grinding your teeth are you?
posted by Coaticass at 1:04 PM on February 3, 2018 [1 favorite]

Some people have found Botox helpful for migraines, perhaps it would be able to help with this as well.
posted by yohko at 1:38 PM on February 3, 2018

The corpse in the library beat me to the post, but your list of issues also sounds to me like PCS: the brain fog, the headaches, the depression, and inertia. Often, brain MRIs won’t pick up concussion-related damage since a lot of the structural damage is subtle, but that doesn’t mean it won’t have huge impacts on your mood, energy levels, and motivation.
posted by heurtebise at 1:47 PM on February 3, 2018 [1 favorite]

Caffiene withdrawal syndrome?
posted by serena15221 at 5:01 PM on February 3, 2018

This v-shaped pillow is my everything. It'll fit inside a King pillowcase btw, you don't need to buy a bunch of extras.
posted by Lyn Never at 6:33 PM on February 3, 2018 [1 favorite]

Nthing a new pillow - I recently was finally able to replace my old flat one and the pain in my neck + shoulders has greatly reduced!
posted by A hidden well at 7:23 PM on February 3, 2018 [1 favorite]

Should have added - my new pillow is just a thick fluffy department store one, so nothing special. I'm also a side sleeper and I can now feel it supporting my neck without raising my head too high.
posted by A hidden well at 7:25 PM on February 3, 2018 [1 favorite]

I'm on team Multiple Pillows. Pillows are like toothbrushes, they need replacing periodically.
Also, you can stuff a pillowcase with a blanket or a solid foam object from a hobby or fabric store and see how that works. Check where quilting supplies are sold.
posted by TrishaU at 12:23 AM on February 4, 2018

I always used to use down pillows, which gradually deflated. A few years ago when we got a new mattress, I tried what seemed like a ridiculously expensive Tempur pillow. It felt good, and, as we were getting a discount on the mattress, I decided to take a chance on it. One of the best purchases I ever made. Unlike down pillows, it's always the same - never needs fluffing up or folding or doubling up - the single pillow does the job. It has helped me feel less foggy in the morning. (I usually sleep on my side, sometimes on my back.) Over 2 years later, the pillow still feels the same.
posted by snarfois at 8:26 AM on February 4, 2018 [1 favorite]

Do you grind your teeth? A bite guard cured my early morning headaches; it's worth a try.
posted by pretentious illiterate at 9:12 AM on February 4, 2018 [1 favorite]

IANAD at all, but it sounds very suggestive that you have cerebral palsy and you get significant relief from a drug which treats muscle spasticity. It might be as simple as your muscles just seizing up and giving you pain which interferes with all of your other functioning. Apparently Baclofen can be administered using an implantable pump which gets it straight into your spinal cord, allowing for constant dosing, and this is something that's sometimes used for uncontrolled muscle spasms in cerebral palsy. Might be worth asking about, at least.
posted by Acheman at 7:54 AM on February 7, 2018 [1 favorite]